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Chakera A, Harrison S, Mitchell J, Oliver C, Ralph M, Shelton C. The Nitrous Oxide Project: assessment of advocacy and national directives to deliver mitigation of anaesthetic nitrous oxide. Anaesthesia 2024; 79:270-277. [PMID: 38205565 DOI: 10.1111/anae.16211] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2023] [Indexed: 01/12/2024]
Abstract
The environmental emissions attributed to anaesthetic nitrous oxide across the NHS are comparable to the carbon dioxide released by 135,000 flights from Frankfurt to New York. Much of these emissions are attributable to cumbersome and inadequately managed piped systems, resulting in excessive loss and waste. Since 2020, multiple hospital sites have been engaging with the Nitrous Oxide Project, a quality improvement method supporting a 'lean systems' approach to the provision of nitrous oxide. This review considers the frameworks supporting medical gas management in UK healthcare systems, and the impact of professional advocacy and medical gas stewardship to drive anaesthetic nitrous oxide mitigation in the NHS. Nitrous oxide mitigation efforts by grassroots and professional advocacy networks are enhanced through national centralised emission monitoring, distribution of data, technical information and provision of quality analysis. Given the climate harms of nitrous oxide, concerted efforts should be made to rationalise its use, and resources should be committed to supporting this at local, regional and national levels.
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Affiliation(s)
- A Chakera
- Health Infrastructure and Sustainability, Scottish Government, Edinburgh, UK
- The Nitrous Oxide Project, Edinburgh, UK
| | - S Harrison
- Northwest School of Anaesthesia, Manchester, UK
| | - J Mitchell
- Department of Anaesthesia, University Hospital Ayr, Ayr, UK
| | - C Oliver
- Department of Anaesthesia, University Hospital of Wales, Cardiff, UK
| | - M Ralph
- Engineering and Assurance, NHS Scotland Assure, Glasgow, UK
| | - C Shelton
- Department of Anaesthesia, Wythenshawe Hospital, Manchester, UK
- Lancaster Medical School, Lancaster University, Lancaster, UK
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Wolff J, Smollich M, Wuelfing P, Mitchell J, Wuerstlein R, Harbeck N, Baumann F. App-Based Lifestyle Intervention (PINK! Coach) in Breast Cancer Patients-A Real-World-Data Analysis. Cancers (Basel) 2024; 16:1020. [PMID: 38473378 DOI: 10.3390/cancers16051020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 02/21/2024] [Accepted: 02/23/2024] [Indexed: 03/14/2024] Open
Abstract
INTRODUCTION Overweight and a lack of physical activity not only increase the risk of recurrence in breast cancer patients but also negatively impact overall and long-term survival, as well as quality of life. The results presented here are the first real-world data from the DiGA PINK! Coach examining the physical activity and BMI of app users. Based on the literature, an approximate weight gain of 10% over 6 months and a decrease in physical activity can be expected. The purpose of this study is to retrospectively investigate the effects of the PINK! Coach in a real-world setting on patients' BMI and physical activity level during acute therapies. such as chemotherapy (CHT) and antihormone therapy (AHT). MATERIAL AND METHODS The PINK! Coach app accompanies breast cancer patients during and after acute therapy to bring about a sustainable lifestyle change. The patients are encouraged to establish a healthy diet, become physically active, and make informed decisions. In this study, real-world data from the app were analyzed over 6 months from baseline to T1 (after 12 weeks) and T2 (after 24 weeks). The patients were under acute therapy or in follow-up care receiving either CHT or AHT. RESULTS The analyzed data indicate that all patients were able to maintain a consistent BMI over 6 months independent of pre-defined subgroups such as AHT, CHT, or BMI subgroups. In the subgroup of patients undergoing AHT, overweight patients were even able to significantly reduce their BMI by 1-score-point over 6 months (p < 0.01). The subgroup of patients undergoing CHT also showed an significant overall reduction in BMI (p = 0.01). All patients were also able to significantly increase their daily step count as well as their physical activity minutes per day. After the first 12 weeks, 41.4% of patients experienced weight gain, 33.4% were able to maintain their weight, and 24.2% reduced their weight. CONCLUSION The presented data provides intriguing insights into the users of the PINK! Coach app and the impact of this usage in regards to BMI and physical activity. At the current time, there are only a few effective concepts for encouraging all breast cancer patients to engage in moderate physical activity and reduce body weight. Often, these concepts apply to selected patient groups. The data presented here include all age groups, tumor stages, and therapies, providing an initial insight into a comprehensive approach. Data over an even longer period would be one way to better contextualize the results in current research.
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Affiliation(s)
- Josefine Wolff
- Breast Center, Department of Gynecology and Obstetrics, Comprehensive Cancer Center, LMU University Hospital, 80336 Munich, Germany
| | - Martin Smollich
- Institute of Nutritional Medicine, University Hospital Schleswig-Holstein, 23538 Luebeck, Germany
| | - Pia Wuelfing
- Department Clinical Research, PINK! gegen Brustkrebs GmbH, 20251 Hamburg, Germany
| | - Jack Mitchell
- Department Clinical Research, PINK! gegen Brustkrebs GmbH, 20251 Hamburg, Germany
| | - Rachel Wuerstlein
- Breast Center, Department of Gynecology and Obstetrics, Comprehensive Cancer Center, LMU University Hospital, 80336 Munich, Germany
| | - Nadia Harbeck
- Breast Center, Department of Gynecology and Obstetrics, Comprehensive Cancer Center, LMU University Hospital, 80336 Munich, Germany
| | - Freerk Baumann
- Department I of Internal Medicine, University of Cologne, 50923 Cologne, Germany
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Clanchy K, Mitchell J, Mulholland K, Jurd E, Kendall E, Lloyd DG, Palipana D, Pizzolato C, Shirota C. Towards co-design of rehabilitation technologies: a collaborative approach to prioritize usability issues. Front Rehabil Sci 2024; 5:1302179. [PMID: 38450206 PMCID: PMC10915061 DOI: 10.3389/fresc.2024.1302179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 02/05/2024] [Indexed: 03/08/2024]
Abstract
Introduction Early stakeholder engagement is critical to the successful development and translation of rehabilitation technologies, a pivotal step of which is usability testing with intended end-users. To this end, several methods employ end-user feedback to identify usability and implementation issues. However, the process of prioritizing identified issues seldom leverages the knowledge and expertise of the range of stakeholders who will ultimately affect the demand and supply of a device. This paper describes a novel method to prioritize end-user feedback using transdisciplinary stakeholder consultation and address it in subsequent product development. The proposed approach was demonstrated using a case study relating to the development of a novel technology for neural recovery after spinal cord injury. Method Feedback from five individuals with chronic spinal cord injury was collected during two-hour usability evaluation sessions with a fully functional high-fidelity system prototype. A think-aloud and semi-structured interview protocol was used with each participant to identify usability and acceptability issues relating to the system in a 3-phase approach. Phase 1 involved extracting usability issues from think-aloud and semi-structured interview data. Phase 2 involved rating the usability issues based on their significance, technical feasibility, and implementation priority by relevant internal and external stakeholders. Finally, Phase 3 involved aggregating the usability issues according to design and implementation elements to facilitate solution generation, and these solutions were then raised as action tasks for future design iterations. Results Sixty usability issues representing nine facets of usability were rated. Eighty percent of issues were rated to be of moderate to high significance, 83% were rated as being feasible to address, and 75% were rated as addressable using existing project resources. Fifty percent of the issues were rated to be a high priority for implementation. Evaluation of the grouped issues identified 21 tasks which were mapped to the product roadmap for integration into future design iterations. Discussion This paper presents a method for meaningful transdisciplinary stakeholder engagement in rehabilitation technology development that can extended to other projects. Alongside a worked example, we offer practical considerations for others seeking to co-develop rehabilitation technologies.
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Affiliation(s)
- K. Clanchy
- School of Health Sciences and Social Work, Griffith University, Southport, QLD, Australia
- The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Nathan, QLD, Australia
| | - J. Mitchell
- The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Nathan, QLD, Australia
| | - K. Mulholland
- Griffith Centre of Biomedical and Rehabilitation Engineering, Menzies Health Institute Queensland, Griffith University, Southport, QLD, Australia
- Advanced Design and Prototyping Technologies Institute, Menzies Health Institute Queensland, Southport, QLD, Australia
| | - E. Jurd
- Griffith Centre of Biomedical and Rehabilitation Engineering, Menzies Health Institute Queensland, Griffith University, Southport, QLD, Australia
- Advanced Design and Prototyping Technologies Institute, Menzies Health Institute Queensland, Southport, QLD, Australia
| | - E. Kendall
- School of Health Sciences and Social Work, Griffith University, Southport, QLD, Australia
- The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Nathan, QLD, Australia
| | - D. G. Lloyd
- School of Health Sciences and Social Work, Griffith University, Southport, QLD, Australia
- Griffith Centre of Biomedical and Rehabilitation Engineering, Menzies Health Institute Queensland, Griffith University, Southport, QLD, Australia
- Advanced Design and Prototyping Technologies Institute, Menzies Health Institute Queensland, Southport, QLD, Australia
| | - D. Palipana
- Emergency Department, Gold Coast University Hospital, Southport, QLD, Australia
| | - C. Pizzolato
- School of Health Sciences and Social Work, Griffith University, Southport, QLD, Australia
- Griffith Centre of Biomedical and Rehabilitation Engineering, Menzies Health Institute Queensland, Griffith University, Southport, QLD, Australia
- Advanced Design and Prototyping Technologies Institute, Menzies Health Institute Queensland, Southport, QLD, Australia
| | - C. Shirota
- The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Nathan, QLD, Australia
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Raman B, McCracken C, Cassar MP, Moss AJ, Finnigan L, Samat AHA, Ogbole G, Tunnicliffe EM, Alfaro-Almagro F, Menke R, Xie C, Gleeson F, Lukaschuk E, Lamlum H, McGlynn K, Popescu IA, Sanders ZB, Saunders LC, Piechnik SK, Ferreira VM, Nikolaidou C, Rahman NM, Ho LP, Harris VC, Shikotra A, Singapuri A, Pfeffer P, Manisty C, Kon OM, Beggs M, O'Regan DP, Fuld J, Weir-McCall JR, Parekh D, Steeds R, Poinasamy K, Cuthbertson DJ, Kemp GJ, Semple MG, Horsley A, Miller CA, O'Brien C, Shah AM, Chiribiri A, Leavy OC, Richardson M, Elneima O, McAuley HJC, Sereno M, Saunders RM, Houchen-Wolloff L, Greening NJ, Bolton CE, Brown JS, Choudhury G, Diar Bakerly N, Easom N, Echevarria C, Marks M, Hurst JR, Jones MG, Wootton DG, Chalder T, Davies MJ, De Soyza A, Geddes JR, Greenhalf W, Howard LS, Jacob J, Man WDC, Openshaw PJM, Porter JC, Rowland MJ, Scott JT, Singh SJ, Thomas DC, Toshner M, Lewis KE, Heaney LG, Harrison EM, Kerr S, Docherty AB, Lone NI, Quint J, Sheikh A, Zheng B, Jenkins RG, Cox E, Francis S, Halling-Brown M, Chalmers JD, Greenwood JP, Plein S, Hughes PJC, Thompson AAR, Rowland-Jones SL, Wild JM, Kelly M, Treibel TA, Bandula S, Aul R, Miller K, Jezzard P, Smith S, Nichols TE, McCann GP, Evans RA, Wain LV, Brightling CE, Neubauer S, Baillie JK, Shaw A, Hairsine B, Kurasz C, Henson H, Armstrong L, Shenton L, Dobson H, Dell A, Lucey A, Price A, Storrie A, Pennington C, Price C, Mallison G, Willis G, Nassa H, Haworth J, Hoare M, Hawkings N, Fairbairn S, Young S, Walker S, Jarrold I, Sanderson A, David C, Chong-James K, Zongo O, James WY, Martineau A, King B, Armour C, McAulay D, Major E, McGinness J, McGarvey L, Magee N, Stone R, Drain S, Craig T, Bolger A, Haggar A, Lloyd A, Subbe C, Menzies D, Southern D, McIvor E, Roberts K, Manley R, Whitehead V, Saxon W, Bularga A, Mills NL, El-Taweel H, Dawson J, Robinson L, Saralaya D, Regan K, Storton K, Brear L, Amoils S, Bermperi A, Elmer A, Ribeiro C, Cruz I, Taylor J, Worsley J, Dempsey K, Watson L, Jose S, Marciniak S, Parkes M, McQueen A, Oliver C, Williams J, Paradowski K, Broad L, Knibbs L, Haynes M, Sabit R, Milligan L, Sampson C, Hancock A, Evenden C, Lynch C, Hancock K, Roche L, Rees M, Stroud N, Thomas-Woods T, Heller S, Robertson E, Young B, Wassall H, Babores M, Holland M, Keenan N, Shashaa S, Price C, Beranova E, Ramos H, Weston H, Deery J, Austin L, Solly R, Turney S, Cosier T, Hazelton T, Ralser M, Wilson A, Pearce L, Pugmire S, Stoker W, McCormick W, Dewar A, Arbane G, Kaltsakas G, Kerslake H, Rossdale J, Bisnauthsing K, Aguilar Jimenez LA, Martinez LM, Ostermann M, Magtoto MM, Hart N, Marino P, Betts S, Solano TS, Arias AM, Prabhu A, Reed A, Wrey Brown C, Griffin D, Bevan E, Martin J, Owen J, Alvarez Corral M, Williams N, Payne S, Storrar W, Layton A, Lawson C, Mills C, Featherstone J, Stephenson L, Burdett T, Ellis Y, Richards A, Wright C, Sykes DL, Brindle K, Drury K, Holdsworth L, Crooks MG, Atkin P, Flockton R, Thackray-Nocera S, Mohamed A, Taylor A, Perkins E, Ross G, McGuinness H, Tench H, Phipps J, Loosley R, Wolf-Roberts R, Coetzee S, Omar Z, Ross A, Card B, Carr C, King C, Wood C, Copeland D, Calvelo E, Chilvers ER, Russell E, Gordon H, Nunag JL, Schronce J, March K, Samuel K, Burden L, Evison L, McLeavey L, Orriss-Dib L, Tarusan L, Mariveles M, Roy M, Mohamed N, Simpson N, Yasmin N, Cullinan P, Daly P, Haq S, Moriera S, Fayzan T, Munawar U, Nwanguma U, Lingford-Hughes A, Altmann D, Johnston D, Mitchell J, Valabhji J, Price L, Molyneaux PL, Thwaites RS, Walsh S, Frankel A, Lightstone L, Wilkins M, Willicombe M, McAdoo S, Touyz R, Guerdette AM, Warwick K, Hewitt M, Reddy R, White S, McMahon A, Hoare A, Knighton A, Ramos A, Te A, Jolley CJ, Speranza F, Assefa-Kebede H, Peralta I, Breeze J, Shevket K, Powell N, Adeyemi O, Dulawan P, Adrego R, Byrne S, Patale S, Hayday A, Malim M, Pariante C, Sharpe C, Whitney J, Bramham K, Ismail K, Wessely S, Nicholson T, Ashworth A, Humphries A, Tan AL, Whittam B, Coupland C, Favager C, Peckham D, Wade E, Saalmink G, Clarke J, Glossop J, Murira J, Rangeley J, Woods J, Hall L, Dalton M, Window N, Beirne P, Hardy T, Coakley G, Turtle L, Berridge A, Cross A, Key AL, Rowe A, Allt AM, Mears C, Malein F, Madzamba G, Hardwick HE, Earley J, Hawkes J, Pratt J, Wyles J, Tripp KA, Hainey K, Allerton L, Lavelle-Langham L, Melling L, Wajero LO, Poll L, Noonan MJ, French N, Lewis-Burke N, Williams-Howard SA, Cooper S, Kaprowska S, Dobson SL, Marsh S, Highett V, Shaw V, Beadsworth M, Defres S, Watson E, Tiongson GF, Papineni P, Gurram S, Diwanji SN, Quaid S, Briggs A, Hastie C, Rogers N, Stensel D, Bishop L, McIvor K, Rivera-Ortega P, Al-Sheklly B, Avram C, Faluyi D, Blaikely J, Piper Hanley K, Radhakrishnan K, Buch M, Hanley NA, Odell N, Osbourne R, Stockdale S, Felton T, Gorsuch T, Hussell T, Kausar Z, Kabir T, McAllister-Williams H, Paddick S, Burn D, Ayoub A, Greenhalgh A, Sayer A, Young A, Price D, Burns G, MacGowan G, Fisher H, Tedd H, Simpson J, Jiwa K, Witham M, Hogarth P, West S, Wright S, McMahon MJ, Neill P, Dougherty A, Morrow A, Anderson D, Grieve D, Bayes H, Fallon K, Mangion K, Gilmour L, Basu N, Sykes R, Berry C, McInnes IB, Donaldson A, Sage EK, Barrett F, Welsh B, Bell M, Quigley J, Leitch K, Macliver L, Patel M, Hamil R, Deans A, Furniss J, Clohisey S, Elliott A, Solstice AR, Deas C, Tee C, Connell D, Sutherland D, George J, Mohammed S, Bunker J, Holmes K, Dipper A, Morley A, Arnold D, Adamali H, Welch H, Morrison L, Stadon L, Maskell N, Barratt S, Dunn S, Waterson S, Jayaraman B, Light T, Selby N, Hosseini A, Shaw K, Almeida P, Needham R, Thomas AK, Matthews L, Gupta A, Nikolaidis A, Dupont C, Bonnington J, Chrystal M, Greenhaff PL, Linford S, Prosper S, Jang W, Alamoudi A, Bloss A, Megson C, Nicoll D, Fraser E, Pacpaco E, Conneh F, Ogg G, McShane H, Koychev I, Chen J, Pimm J, Ainsworth M, Pavlides M, Sharpe M, Havinden-Williams M, Petousi N, Talbot N, Carter P, Kurupati P, Dong T, Peng Y, Burns A, Kanellakis N, Korszun A, Connolly B, Busby J, Peto T, Patel B, Nolan CM, Cristiano D, Walsh JA, Liyanage K, Gummadi M, Dormand N, Polgar O, George P, Barker RE, Patel S, Price L, Gibbons M, Matila D, Jarvis H, Lim L, Olaosebikan O, Ahmad S, Brill S, Mandal S, Laing C, Michael A, Reddy A, Johnson C, Baxendale H, Parfrey H, Mackie J, Newman J, Pack J, Parmar J, Paques K, Garner L, Harvey A, Summersgill C, Holgate D, Hardy E, Oxton J, Pendlebury J, McMorrow L, Mairs N, Majeed N, Dark P, Ugwuoke R, Knight S, Whittaker S, Strong-Sheldrake S, Matimba-Mupaya W, Chowienczyk P, Pattenadk D, Hurditch E, Chan F, Carborn H, Foot H, Bagshaw J, Hockridge J, Sidebottom J, Lee JH, Birchall K, Turner K, Haslam L, Holt L, Milner L, Begum M, Marshall M, Steele N, Tinker N, Ravencroft P, Butcher R, Misra S, Walker S, Coburn Z, Fairman A, Ford A, Holbourn A, Howell A, Lawrie A, Lye A, Mbuyisa A, Zawia A, Holroyd-Hind B, Thamu B, Clark C, Jarman C, Norman C, Roddis C, Foote D, Lee E, Ilyas F, Stephens G, Newell H, Turton H, Macharia I, Wilson I, Cole J, McNeill J, Meiring J, Rodger J, Watson J, Chapman K, Harrington K, Chetham L, Hesselden L, Nwafor L, Dixon M, Plowright M, Wade P, Gregory R, Lenagh R, Stimpson R, Megson S, Newman T, Cheng Y, Goodwin C, Heeley C, Sissons D, Sowter D, Gregory H, Wynter I, Hutchinson J, Kirk J, Bennett K, Slack K, Allsop L, Holloway L, Flynn M, Gill M, Greatorex M, Holmes M, Buckley P, Shelton S, Turner S, Sewell TA, Whitworth V, Lovegrove W, Tomlinson J, Warburton L, Painter S, Vickers C, Redwood D, Tilley J, Palmer S, Wainwright T, Breen G, Hotopf M, Dunleavy A, Teixeira J, Ali M, Mencias M, Msimanga N, Siddique S, Samakomva T, Tavoukjian V, Forton D, Ahmed R, Cook A, Thaivalappil F, Connor L, Rees T, McNarry M, Williams N, McCormick J, McIntosh J, Vere J, Coulding M, Kilroy S, Turner V, Butt AT, Savill H, Fraile E, Ugoji J, Landers G, Lota H, Portukhay S, Nasseri M, Daniels A, Hormis A, Ingham J, Zeidan L, Osborne L, Chablani M, Banerjee A, David A, Pakzad A, Rangelov B, Williams B, Denneny E, Willoughby J, Xu M, Mehta P, Batterham R, Bell R, Aslani S, Lilaonitkul W, Checkley A, Bang D, Basire D, Lomas D, Wall E, Plant H, Roy K, Heightman M, Lipman M, Merida Morillas M, Ahwireng N, Chambers RC, Jastrub R, Logan S, Hillman T, Botkai A, Casey A, Neal A, Newton-Cox A, Cooper B, Atkin C, McGee C, Welch C, Wilson D, Sapey E, Qureshi H, Hazeldine J, Lord JM, Nyaboko J, Short J, Stockley J, Dasgin J, Draxlbauer K, Isaacs K, Mcgee K, Yip KP, Ratcliffe L, Bates M, Ventura M, Ahmad Haider N, Gautam N, Baggott R, Holden S, Madathil S, Walder S, Yasmin S, Hiwot T, Jackson T, Soulsby T, Kamwa V, Peterkin Z, Suleiman Z, Chaudhuri N, Wheeler H, Djukanovic R, Samuel R, Sass T, Wallis T, Marshall B, Childs C, Marouzet E, Harvey M, Fletcher S, Dickens C, Beckett P, Nanda U, Daynes E, Charalambou A, Yousuf AJ, Lea A, Prickett A, Gooptu B, Hargadon B, Bourne C, Christie C, Edwardson C, Lee D, Baldry E, Stringer E, Woodhead F, Mills G, Arnold H, Aung H, Qureshi IN, Finch J, Skeemer J, Hadley K, Khunti K, Carr L, Ingram L, Aljaroof M, Bakali M, Bakau M, Baldwin M, Bourne M, Pareek M, Soares M, Tobin M, Armstrong N, Brunskill N, Goodman N, Cairns P, Haldar P, McCourt P, Dowling R, Russell R, Diver S, Edwards S, Glover S, Parker S, Siddiqui S, Ward TJC, Mcnally T, Thornton T, Yates T, Ibrahim W, Monteiro W, Thickett D, Wilkinson D, Broome M, McArdle P, Upthegrove R, Wraith D, Langenberg C, Summers C, Bullmore E, Heeney JL, Schwaeble W, Sudlow CL, Adeloye D, Newby DE, Rudan I, Shankar-Hari M, Thorpe M, Pius R, Walmsley S, McGovern A, Ballard C, Allan L, Dennis J, Cavanagh J, Petrie J, O'Donnell K, Spears M, Sattar N, MacDonald S, Guthrie E, Henderson M, Guillen Guio B, Zhao B, Lawson C, Overton C, Taylor C, Tong C, Mukaetova-Ladinska E, Turner E, Pearl JE, Sargant J, Wormleighton J, Bingham M, Sharma M, Steiner M, Samani N, Novotny P, Free R, Allen RJ, Finney S, Terry S, Brugha T, Plekhanova T, McArdle A, Vinson B, Spencer LG, Reynolds W, Ashworth M, Deakin B, Chinoy H, Abel K, Harvie M, Stanel S, Rostron A, Coleman C, Baguley D, Hufton E, Khan F, Hall I, Stewart I, Fabbri L, Wright L, Kitterick P, Morriss R, Johnson S, Bates A, Antoniades C, Clark D, Bhui K, Channon KM, Motohashi K, Sigfrid L, Husain M, Webster M, Fu X, Li X, Kingham L, Klenerman P, Miiler K, Carson G, Simons G, Huneke N, Calder PC, Baldwin D, Bain S, Lasserson D, Daines L, Bright E, Stern M, Crisp P, Dharmagunawardena R, Reddington A, Wight A, Bailey L, Ashish A, Robinson E, Cooper J, Broadley A, Turnbull A, Brookes C, Sarginson C, Ionita D, Redfearn H, Elliott K, Barman L, Griffiths L, Guy Z, Gill R, Nathu R, Harris E, Moss P, Finnigan J, Saunders K, Saunders P, Kon S, Kon SS, O'Brien L, Shah K, Shah P, Richardson E, Brown V, Brown M, Brown J, Brown J, Brown A, Brown A, Brown M, Choudhury N, Jones S, Jones H, Jones L, Jones I, Jones G, Jones H, Jones D, Davies F, Davies E, Davies K, Davies G, Davies GA, Howard K, Porter J, Rowland J, Rowland A, Scott K, Singh S, Singh C, Thomas S, Thomas C, Lewis V, Lewis J, Lewis D, Harrison P, Francis C, Francis R, Hughes RA, Hughes J, Hughes AD, Thompson T, Kelly S, Smith D, Smith N, Smith A, Smith J, Smith L, Smith S, Evans T, Evans RI, Evans D, Evans R, Evans H, Evans J. Multiorgan MRI findings after hospitalisation with COVID-19 in the UK (C-MORE): a prospective, multicentre, observational cohort study. Lancet Respir Med 2023; 11:1003-1019. [PMID: 37748493 PMCID: PMC7615263 DOI: 10.1016/s2213-2600(23)00262-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 06/16/2023] [Accepted: 06/30/2023] [Indexed: 09/27/2023]
Abstract
INTRODUCTION The multiorgan impact of moderate to severe coronavirus infections in the post-acute phase is still poorly understood. We aimed to evaluate the excess burden of multiorgan abnormalities after hospitalisation with COVID-19, evaluate their determinants, and explore associations with patient-related outcome measures. METHODS In a prospective, UK-wide, multicentre MRI follow-up study (C-MORE), adults (aged ≥18 years) discharged from hospital following COVID-19 who were included in Tier 2 of the Post-hospitalisation COVID-19 study (PHOSP-COVID) and contemporary controls with no evidence of previous COVID-19 (SARS-CoV-2 nucleocapsid antibody negative) underwent multiorgan MRI (lungs, heart, brain, liver, and kidneys) with quantitative and qualitative assessment of images and clinical adjudication when relevant. Individuals with end-stage renal failure or contraindications to MRI were excluded. Participants also underwent detailed recording of symptoms, and physiological and biochemical tests. The primary outcome was the excess burden of multiorgan abnormalities (two or more organs) relative to controls, with further adjustments for potential confounders. The C-MORE study is ongoing and is registered with ClinicalTrials.gov, NCT04510025. FINDINGS Of 2710 participants in Tier 2 of PHOSP-COVID, 531 were recruited across 13 UK-wide C-MORE sites. After exclusions, 259 C-MORE patients (mean age 57 years [SD 12]; 158 [61%] male and 101 [39%] female) who were discharged from hospital with PCR-confirmed or clinically diagnosed COVID-19 between March 1, 2020, and Nov 1, 2021, and 52 non-COVID-19 controls from the community (mean age 49 years [SD 14]; 30 [58%] male and 22 [42%] female) were included in the analysis. Patients were assessed at a median of 5·0 months (IQR 4·2-6·3) after hospital discharge. Compared with non-COVID-19 controls, patients were older, living with more obesity, and had more comorbidities. Multiorgan abnormalities on MRI were more frequent in patients than in controls (157 [61%] of 259 vs 14 [27%] of 52; p<0·0001) and independently associated with COVID-19 status (odds ratio [OR] 2·9 [95% CI 1·5-5·8]; padjusted=0·0023) after adjusting for relevant confounders. Compared with controls, patients were more likely to have MRI evidence of lung abnormalities (p=0·0001; parenchymal abnormalities), brain abnormalities (p<0·0001; more white matter hyperintensities and regional brain volume reduction), and kidney abnormalities (p=0·014; lower medullary T1 and loss of corticomedullary differentiation), whereas cardiac and liver MRI abnormalities were similar between patients and controls. Patients with multiorgan abnormalities were older (difference in mean age 7 years [95% CI 4-10]; mean age of 59·8 years [SD 11·7] with multiorgan abnormalities vs mean age of 52·8 years [11·9] without multiorgan abnormalities; p<0·0001), more likely to have three or more comorbidities (OR 2·47 [1·32-4·82]; padjusted=0·0059), and more likely to have a more severe acute infection (acute CRP >5mg/L, OR 3·55 [1·23-11·88]; padjusted=0·025) than those without multiorgan abnormalities. Presence of lung MRI abnormalities was associated with a two-fold higher risk of chest tightness, and multiorgan MRI abnormalities were associated with severe and very severe persistent physical and mental health impairment (PHOSP-COVID symptom clusters) after hospitalisation. INTERPRETATION After hospitalisation for COVID-19, people are at risk of multiorgan abnormalities in the medium term. Our findings emphasise the need for proactive multidisciplinary care pathways, with the potential for imaging to guide surveillance frequency and therapeutic stratification. FUNDING UK Research and Innovation and National Institute for Health Research.
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Siqueira I, Lin J, Robertson T, Mitchell J, Kohut SA, Donma AJ, Seifert-Hansen M, Telfer H, Anthony S. “We're Not Really By Ourselves Anymore”: Implementation and Effectiveness Evaluation of a Mindfulness-Based Retreat for Mothers of Pediatric Heart Transplant Recipients. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Killean A, Mitchell J, McLaren D. Acute Gastrointestinal and Genitourinary Toxicity from Stereotactic Body Radiotherapy for Prostate Cancer following Continuous Tumour Tracking with the Micropos Medical RayPilot and RayPilot HypoCath System®. Clin Oncol (R Coll Radiol) 2023. [DOI: 10.1016/j.clon.2022.11.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Takata H, Mitchell J, Sacdalan C, Chomont N, Trautmann L, Pagliuzza A, Kakazu J, Pinyakorn S, Phanuphak N, Vasan S, Hsu D. OP 4.4 – 00018 HIV reservoir burden associates with numbers of HIV-specific CD8+ T cells under long-term antiretroviral therapy and prevents them from differentiating into functional memory cells. J Virus Erad 2022. [DOI: 10.1016/j.jve.2022.100204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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Macken WL, Falabella M, McKittrick C, Pizzamiglio C, Ellmers R, Eggleton K, Woodward CE, Patel Y, Labrum R, Phadke R, Reilly MM, DeVile C, Sarkozy A, Footitt E, Davison J, Rahman S, Houlden H, Bugiardini E, Quinlivan R, Hanna MG, Vandrovcova J, Pitceathly RDS, Hubbard TJP, Jackson R, Jones LJ, Kasperaviciute D, Kayikci M, Kousathanas A, Lahnstein L, Lakey A, Leigh SEA, Leong IUS, Lopez FJ, Maleady-Crowe F, McEntagart M, Minneci F, Mitchell J, Moutsianas L, Mueller M, Murugaesu N, Need AC, O’Donovan P, Odhams CA, Patch C, Perez-Gil D, Pereira MB, Pullinger J, Rahim T, Rendon A, Rogers T, Savage K, Sawant K, Scott RH, Siddiq A, Sieghart A, Smith SC, Sosinsky A, Stuckey A, Tanguy M, Taylor Tavares AL, Thomas ERA, Thompson SR, Tucci A, Welland MJ, Williams E, Witkowska K, Wood SM, Zarowiecki M, Phadke R, Reilly MM, DeVile C, Sarkozy A, Footitt E, Davison J, Rahman S, Houlden H, Bugiardini E, Quinlivan R, Hanna MG, Vandrovcova J, Pitceathly RDS. Specialist multidisciplinary input maximises rare disease diagnoses from whole genome sequencing. Nat Commun 2022; 13:6324. [PMID: 36344503 PMCID: PMC9640711 DOI: 10.1038/s41467-022-32908-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 08/24/2022] [Indexed: 11/09/2022] Open
Abstract
Diagnostic whole genome sequencing (WGS) is increasingly used in rare diseases. However, standard, semi-automated WGS analysis may overlook diagnoses in complex disorders. Here, we show that specialist multidisciplinary analysis of WGS, following an initial 'no primary findings' (NPF) report, improves diagnostic rates and alters management. We undertook WGS in 102 adults with diagnostically challenging primary mitochondrial disease phenotypes. NPF cases were reviewed by a genomic medicine team, thus enabling bespoke informatic approaches, co-ordinated phenotypic validation, and functional work. We enhanced the diagnostic rate from 16.7% to 31.4%, with management implications for all new diagnoses, and detected strong candidate disease-causing variants in a further 3.9% of patients. This approach presents a standardised model of care that supports mainstream clinicians and enhances diagnostic equity for complex disorders, thereby facilitating access to the potential benefits of genomic healthcare. This research was made possible through access to the data and findings generated by the 100,000 Genomes Project: http://www.genomicsengland.co.uk .
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Affiliation(s)
- William L. Macken
- grid.83440.3b0000000121901201Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK ,grid.436283.80000 0004 0612 2631NHS Highly Specialised Service for Rare Mitochondrial Disorders, Queen Square Centre for Neuromuscular Diseases, The National Hospital for Neurology and Neurosurgery, London, UK
| | - Micol Falabella
- grid.83440.3b0000000121901201Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
| | - Caroline McKittrick
- grid.83440.3b0000000121901201Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
| | - Chiara Pizzamiglio
- grid.83440.3b0000000121901201Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK ,grid.436283.80000 0004 0612 2631NHS Highly Specialised Service for Rare Mitochondrial Disorders, Queen Square Centre for Neuromuscular Diseases, The National Hospital for Neurology and Neurosurgery, London, UK
| | - Rebecca Ellmers
- Neurogenetics Unit, Rare and Inherited Disease Laboratory, North Thames Genomic Laboratory Hub, London, UK
| | - Kelly Eggleton
- Neurogenetics Unit, Rare and Inherited Disease Laboratory, North Thames Genomic Laboratory Hub, London, UK
| | - Cathy E. Woodward
- grid.436283.80000 0004 0612 2631NHS Highly Specialised Service for Rare Mitochondrial Disorders, Queen Square Centre for Neuromuscular Diseases, The National Hospital for Neurology and Neurosurgery, London, UK ,Neurogenetics Unit, Rare and Inherited Disease Laboratory, North Thames Genomic Laboratory Hub, London, UK
| | - Yogen Patel
- Neurogenetics Unit, Rare and Inherited Disease Laboratory, North Thames Genomic Laboratory Hub, London, UK
| | - Robyn Labrum
- grid.436283.80000 0004 0612 2631NHS Highly Specialised Service for Rare Mitochondrial Disorders, Queen Square Centre for Neuromuscular Diseases, The National Hospital for Neurology and Neurosurgery, London, UK ,Neurogenetics Unit, Rare and Inherited Disease Laboratory, North Thames Genomic Laboratory Hub, London, UK
| | | | - Rahul Phadke
- grid.424537.30000 0004 5902 9895Dubowitz Neuromuscular Centre, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Mary M. Reilly
- grid.83440.3b0000000121901201Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
| | - Catherine DeVile
- grid.424537.30000 0004 5902 9895Department of Neurosciences, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Anna Sarkozy
- grid.424537.30000 0004 5902 9895Dubowitz Neuromuscular Centre, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Emma Footitt
- grid.424537.30000 0004 5902 9895Metabolic Unit, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - James Davison
- grid.424537.30000 0004 5902 9895Metabolic Unit, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK ,grid.420468.cNational Institute for Health and Care Research Great Ormond Street Hospital Biomedical Research Centre, London, UK
| | - Shamima Rahman
- grid.424537.30000 0004 5902 9895Metabolic Unit, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK ,grid.83440.3b0000000121901201Mitochondrial Research Group, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Henry Houlden
- grid.83440.3b0000000121901201Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
| | - Enrico Bugiardini
- grid.83440.3b0000000121901201Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK ,grid.436283.80000 0004 0612 2631NHS Highly Specialised Service for Rare Mitochondrial Disorders, Queen Square Centre for Neuromuscular Diseases, The National Hospital for Neurology and Neurosurgery, London, UK
| | - Rosaline Quinlivan
- grid.83440.3b0000000121901201Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK ,grid.436283.80000 0004 0612 2631NHS Highly Specialised Service for Rare Mitochondrial Disorders, Queen Square Centre for Neuromuscular Diseases, The National Hospital for Neurology and Neurosurgery, London, UK ,grid.424537.30000 0004 5902 9895Dubowitz Neuromuscular Centre, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Michael G. Hanna
- grid.83440.3b0000000121901201Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK ,grid.436283.80000 0004 0612 2631NHS Highly Specialised Service for Rare Mitochondrial Disorders, Queen Square Centre for Neuromuscular Diseases, The National Hospital for Neurology and Neurosurgery, London, UK
| | - Jana Vandrovcova
- grid.83440.3b0000000121901201Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
| | - Robert D. S. Pitceathly
- grid.83440.3b0000000121901201Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK ,grid.436283.80000 0004 0612 2631NHS Highly Specialised Service for Rare Mitochondrial Disorders, Queen Square Centre for Neuromuscular Diseases, The National Hospital for Neurology and Neurosurgery, London, UK
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Massud I, Krovi A, Nishiura K, Ruone S, Li L, Holder A, Gary J, Mills P, Mitchell J, Khalil G, Pan Y, Luecke E, Gatto G, Heneine W, García-Lerma JG, Johnson L, van der Straten A, Dobard C. Safety and efficacy of a biodegradable implant releasing tenofovir alafenamide for vaginal protection in a macaque model. J Antimicrob Chemother 2022; 77:2964-2971. [PMID: 35913838 DOI: 10.1093/jac/dkac252] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 06/24/2022] [Indexed: 01/16/2023] Open
Abstract
OBJECTIVES To advance the initiative of ending the global epidemic, long-lasting HIV protection is needed through sustained release of antiretroviral drugs for months to years. We investigated in macaques the safety and efficacy of biodegradable polycaprolactone implants releasing tenofovir alafenamide for HIV pre-exposure prophylaxis (PrEP). METHODS Implants were administered subcutaneously in the arm using a contraceptive trocar. Efficacy against vaginal simian-HIV (SHIV) infection was investigated in six pigtailed macaques that received two tenofovir alafenamide implants (0.35 mg/day), one in each arm, for a total release rate of tenofovir alafenamide at 0.7 mg/day. Macaques were exposed to SHIV twice weekly for 6 weeks. Statistical analyses were used to compare outcome with eight untreated controls. Histological assessments were performed on skin biopsies collected near implantation sites. RESULTS Median (range) tenofovir diphosphate level in PBMCs was 1519 (1068-1898) fmol/106 cells. All macaques with tenofovir alafenamide implants were protected against vaginal SHIV infection. In contrast, 7/8 controls were infected after a median of 4 SHIV exposures (P = 0.0047). Histological assessment of tissues near tenofovir alafenamide implant sites showed inflammation and necrosis in 5/6 animals, which were not evident by visual inspection. CONCLUSIONS We demonstrated complete protection against vaginal SHIV infection with two implants releasing a total of 0.7 mg of tenofovir alafenamide per day. We also identified tenofovir diphosphate concentrations in PBMCs associated with complete vaginal protection. Consistent with previous findings, we observed adverse local toxicity and necrosis near the tenofovir alafenamide implant site. Improved tenofovir alafenamide implants that are safe and maintain high efficacy have the potential to provide long-lasting protection against vaginal HIV infection.
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Affiliation(s)
- I Massud
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - A Krovi
- RTI International, Research Triangle Park, NC, USA
| | - K Nishiura
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - S Ruone
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - L Li
- RTI International, Research Triangle Park, NC, USA
| | - A Holder
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - J Gary
- Infectious Diseases Pathology Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infection Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - P Mills
- Comparative Medicine Branch, Division of Scientific Resources, National Center for Emerging and Zoonotic Infection Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - J Mitchell
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - G Khalil
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Y Pan
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - E Luecke
- RTI International, Research Triangle Park, NC, USA
| | - G Gatto
- RTI International, Research Triangle Park, NC, USA
| | - W Heneine
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - J G García-Lerma
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - L Johnson
- RTI International, Research Triangle Park, NC, USA
| | - A van der Straten
- Center for AIDS Prevention Studies (CAPS), Department of Medicine, University of California San Francisco, San Francisco, CA and ASTRA Consulting, Kensington, CA, USA
| | - C Dobard
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Evans RA, Leavy OC, Richardson M, Elneima O, McAuley HJC, Shikotra A, Singapuri A, Sereno M, Saunders RM, Harris VC, Houchen-Wolloff L, Aul R, Beirne P, Bolton CE, Brown JS, Choudhury G, Diar-Bakerly N, Easom N, Echevarria C, Fuld J, Hart N, Hurst J, Jones MG, Parekh D, Pfeffer P, Rahman NM, Rowland-Jones SL, Shah AM, Wootton DG, Chalder T, Davies MJ, De Soyza A, Geddes JR, Greenhalf W, Greening NJ, Heaney LG, Heller S, Howard LS, Jacob J, Jenkins RG, Lord JM, Man WDC, McCann GP, Neubauer S, Openshaw PJM, Porter JC, Rowland MJ, Scott JT, Semple MG, Singh SJ, Thomas DC, Toshner M, Lewis KE, Thwaites RS, Briggs A, Docherty AB, Kerr S, Lone NI, Quint J, Sheikh A, Thorpe M, Zheng B, Chalmers JD, Ho LP, Horsley A, Marks M, Poinasamy K, Raman B, Harrison EM, Wain LV, Brightling CE, Abel K, Adamali H, Adeloye D, Adeyemi O, Adrego R, Aguilar Jimenez LA, Ahmad S, Ahmad Haider N, Ahmed R, Ahwireng N, Ainsworth M, Al-Sheklly B, Alamoudi A, Ali M, Aljaroof M, All AM, Allan L, Allen RJ, Allerton L, Allsop L, Almeida P, Altmann D, Alvarez Corral M, Amoils S, Anderson D, Antoniades C, Arbane G, Arias A, Armour C, Armstrong L, Armstrong N, Arnold D, Arnold H, Ashish A, Ashworth A, Ashworth M, Aslani S, Assefa-Kebede H, Atkin C, Atkin P, Aung H, Austin L, Avram C, Ayoub A, Babores M, Baggott R, Bagshaw J, Baguley D, Bailey L, Baillie JK, Bain S, Bakali M, Bakau M, Baldry E, Baldwin D, Ballard C, Banerjee A, Bang B, Barker RE, Barman L, Barratt S, Barrett F, Basire D, Basu N, Bates M, Bates A, Batterham R, Baxendale H, Bayes H, Beadsworth M, Beckett P, Beggs M, Begum M, Bell D, Bell R, Bennett K, Beranova E, Bermperi A, Berridge A, Berry C, Betts S, Bevan E, Bhui K, Bingham M, Birchall K, Bishop L, Bisnauthsing K, Blaikely J, Bloss A, Bolger A, Bonnington J, Botkai A, Bourne C, Bourne M, Bramham K, Brear L, Breen G, Breeze J, Bright E, Brill S, Brindle K, Broad L, Broadley A, Brookes C, Broome M, Brown A, Brown A, Brown J, Brown J, Brown M, Brown M, Brown V, Brugha T, Brunskill N, Buch M, Buckley P, Bularga A, Bullmore E, Burden L, Burdett T, Burn D, Burns G, Burns A, Busby J, Butcher R, Butt A, Byrne S, Cairns P, Calder PC, Calvelo E, Carborn H, Card B, Carr C, Carr L, Carson G, Carter P, Casey A, Cassar M, Cavanagh J, Chablani M, Chambers RC, Chan F, Channon KM, Chapman K, Charalambou A, Chaudhuri N, Checkley A, Chen J, Cheng Y, Chetham L, Childs C, Chilvers ER, Chinoy H, Chiribiri A, Chong-James K, Choudhury N, Chowienczyk P, Christie C, Chrystal M, Clark D, Clark C, Clarke J, Clohisey S, Coakley G, Coburn Z, Coetzee S, Cole J, Coleman C, Conneh F, Connell D, Connolly B, Connor L, Cook A, Cooper B, Cooper J, Cooper S, Copeland D, Cosier T, Coulding M, Coupland C, Cox E, Craig T, Crisp P, Cristiano D, Crooks MG, Cross A, Cruz I, Cullinan P, Cuthbertson D, Daines L, Dalton M, Daly P, Daniels A, Dark P, Dasgin J, David A, David C, Davies E, Davies F, Davies G, Davies GA, Davies K, Dawson J, Daynes E, Deakin B, Deans A, Deas C, Deery J, Defres S, Dell A, Dempsey K, Denneny E, Dennis J, Dewar A, Dharmagunawardena R, Dickens C, Dipper A, Diver S, Diwanji SN, Dixon M, Djukanovic R, Dobson H, Dobson SL, Donaldson A, Dong T, Dormand N, Dougherty A, Dowling R, Drain S, Draxlbauer K, Drury K, Dulawan P, Dunleavy A, Dunn S, Earley J, Edwards S, Edwardson C, El-Taweel H, Elliott A, Elliott K, Ellis Y, Elmer A, Evans D, Evans H, Evans J, Evans R, Evans RI, Evans T, Evenden C, Evison L, Fabbri L, Fairbairn S, Fairman A, Fallon K, Faluyi D, Favager C, Fayzan T, Featherstone J, Felton T, Finch J, Finney S, Finnigan J, Finnigan L, Fisher H, Fletcher S, Flockton R, Flynn M, Foot H, Foote D, Ford A, Forton D, Fraile E, Francis C, Francis R, Francis S, Frankel A, Fraser E, Free R, French N, Fu X, Furniss J, Garner L, Gautam N, George J, George P, Gibbons M, Gill M, Gilmour L, Gleeson F, Glossop J, Glover S, Goodman N, Goodwin C, Gooptu B, Gordon H, Gorsuch T, Greatorex M, Greenhaff PL, Greenhalgh A, Greenwood J, Gregory H, Gregory R, Grieve D, Griffin D, Griffiths L, Guerdette AM, Guillen Guio B, Gummadi M, Gupta A, Gurram S, Guthrie E, Guy Z, H Henson H, Hadley K, Haggar A, Hainey K, Hairsine B, Haldar P, Hall I, Hall L, Halling-Brown M, Hamil R, Hancock A, Hancock K, Hanley NA, Haq S, Hardwick HE, Hardy E, Hardy T, Hargadon B, Harrington K, Harris E, Harrison P, Harvey A, Harvey M, Harvie M, Haslam L, Havinden-Williams M, Hawkes J, Hawkings N, Haworth J, Hayday A, Haynes M, Hazeldine J, Hazelton T, Heeley C, Heeney JL, Heightman M, Henderson M, Hesselden L, Hewitt M, Highett V, Hillman T, Hiwot T, Hoare A, Hoare M, Hockridge J, Hogarth P, Holbourn A, Holden S, Holdsworth L, Holgate D, Holland M, Holloway L, Holmes K, Holmes M, Holroyd-Hind B, Holt L, Hormis A, Hosseini A, Hotopf M, Howard K, Howell A, Hufton E, Hughes AD, Hughes J, Hughes R, Humphries A, Huneke N, Hurditch E, Husain M, Hussell T, Hutchinson J, Ibrahim W, Ilyas F, Ingham J, Ingram L, Ionita D, Isaacs K, Ismail K, Jackson T, James WY, Jarman C, Jarrold I, Jarvis H, Jastrub R, Jayaraman B, Jezzard P, Jiwa K, Johnson C, Johnson S, Johnston D, Jolley CJ, Jones D, Jones G, Jones H, Jones H, Jones I, Jones L, Jones S, Jose S, Kabir T, Kaltsakas G, Kamwa V, Kanellakis N, Kaprowska S, Kausar Z, Keenan N, Kelly S, Kemp G, Kerslake H, Key AL, Khan F, Khunti K, Kilroy S, King B, King C, Kingham L, Kirk J, Kitterick P, Klenerman P, Knibbs L, Knight S, Knighton A, Kon O, Kon S, Kon SS, Koprowska S, Korszun A, Koychev I, Kurasz C, Kurupati P, Laing C, Lamlum H, Landers G, Langenberg C, Lasserson D, Lavelle-Langham L, Lawrie A, Lawson C, Lawson C, Layton A, Lea A, Lee D, Lee JH, Lee E, Leitch K, Lenagh R, Lewis D, Lewis J, Lewis V, Lewis-Burke N, Li X, Light T, Lightstone L, Lilaonitkul W, Lim L, Linford S, Lingford-Hughes A, Lipman M, Liyanage K, Lloyd A, Logan S, Lomas D, Loosley R, Lota H, Lovegrove W, Lucey A, Lukaschuk E, Lye A, Lynch C, MacDonald S, MacGowan G, Macharia I, Mackie J, Macliver L, Madathil S, Madzamba G, Magee N, Magtoto MM, Mairs N, Majeed N, Major E, Malein F, Malim M, Mallison G, Mandal S, Mangion K, Manisty C, Manley R, March K, Marciniak S, Marino P, Mariveles M, Marouzet E, Marsh S, Marshall B, Marshall M, Martin J, Martineau A, Martinez LM, Maskell N, Matila D, Matimba-Mupaya W, Matthews L, Mbuyisa A, McAdoo S, Weir McCall J, McAllister-Williams H, McArdle A, McArdle P, McAulay D, McCormick J, McCormick W, McCourt P, McGarvey L, McGee C, Mcgee K, McGinness J, McGlynn K, McGovern A, McGuinness H, McInnes IB, McIntosh J, McIvor E, McIvor K, McLeavey L, McMahon A, McMahon MJ, McMorrow L, Mcnally T, McNarry M, McNeill J, McQueen A, McShane H, Mears C, Megson C, Megson S, Mehta P, Meiring J, Melling L, Mencias M, Menzies D, Merida Morillas M, Michael A, Milligan L, Miller C, Mills C, Mills NL, Milner L, Misra S, Mitchell J, Mohamed A, Mohamed N, Mohammed S, Molyneaux PL, Monteiro W, Moriera S, Morley A, Morrison L, Morriss R, Morrow A, Moss AJ, Moss P, Motohashi K, Msimanga N, Mukaetova-Ladinska E, Munawar U, Murira J, Nanda U, Nassa H, Nasseri M, Neal A, Needham R, Neill P, Newell H, Newman T, Newton-Cox A, Nicholson T, Nicoll D, Nolan CM, Noonan MJ, Norman C, Novotny P, Nunag J, Nwafor L, Nwanguma U, Nyaboko J, O'Donnell K, O'Brien C, O'Brien L, O'Regan D, Odell N, Ogg G, Olaosebikan O, Oliver C, Omar Z, Orriss-Dib L, Osborne L, Osbourne R, Ostermann M, Overton C, Owen J, Oxton J, Pack J, Pacpaco E, Paddick S, Painter S, Pakzad A, Palmer S, Papineni P, Paques K, Paradowski K, Pareek M, Parfrey H, Pariante C, Parker S, Parkes M, Parmar J, Patale S, Patel B, Patel M, Patel S, Pattenadk D, Pavlides M, Payne S, Pearce L, Pearl JE, Peckham D, Pendlebury J, Peng Y, Pennington C, Peralta I, Perkins E, Peterkin Z, Peto T, Petousi N, Petrie J, Phipps J, Pimm J, Piper Hanley K, Pius R, Plant H, Plein S, Plekhanova T, Plowright M, Polgar O, Poll L, Porter J, Portukhay S, Powell N, Prabhu A, Pratt J, Price A, Price C, Price C, Price D, Price L, Price L, Prickett A, Propescu J, Pugmire S, Quaid S, Quigley J, Qureshi H, Qureshi IN, Radhakrishnan K, Ralser M, Ramos A, Ramos H, Rangeley J, Rangelov B, Ratcliffe L, Ravencroft P, Reddington A, Reddy R, Redfearn H, Redwood D, Reed A, Rees M, Rees T, Regan K, Reynolds W, Ribeiro C, Richards A, Richardson E, Rivera-Ortega P, Roberts K, Robertson E, Robinson E, Robinson L, Roche L, Roddis C, Rodger J, Ross A, Ross G, Rossdale J, Rostron A, Rowe A, Rowland A, Rowland J, Roy K, Roy M, Rudan I, Russell R, Russell E, Saalmink G, Sabit R, Sage EK, Samakomva T, Samani N, Sampson C, Samuel K, Samuel R, Sanderson A, Sapey E, Saralaya D, Sargant J, Sarginson C, Sass T, Sattar N, Saunders K, Saunders P, Saunders LC, Savill H, Saxon W, Sayer A, Schronce J, Schwaeble W, Scott K, Selby N, Sewell TA, Shah K, Shah P, Shankar-Hari M, Sharma M, Sharpe C, Sharpe M, Shashaa S, Shaw A, Shaw K, Shaw V, Shelton S, Shenton L, Shevket K, Short J, Siddique S, Siddiqui S, Sidebottom J, Sigfrid L, Simons G, Simpson J, Simpson N, Singh C, Singh S, Sissons D, Skeemer J, Slack K, Smith A, Smith D, Smith S, Smith J, Smith L, Soares M, Solano TS, Solly R, Solstice AR, Soulsby T, Southern D, Sowter D, Spears M, Spencer LG, Speranza F, Stadon L, Stanel S, Steele N, Steiner M, Stensel D, Stephens G, Stephenson L, Stern M, Stewart I, Stimpson R, Stockdale S, Stockley J, Stoker W, Stone R, Storrar W, Storrie A, Storton K, Stringer E, Strong-Sheldrake S, Stroud N, Subbe C, Sudlow CL, Suleiman Z, Summers C, Summersgill C, Sutherland D, Sykes DL, Sykes R, Talbot N, Tan AL, Tarusan L, Tavoukjian V, Taylor A, Taylor C, Taylor J, Te A, Tedd H, Tee CJ, Teixeira J, Tench H, Terry S, Thackray-Nocera S, Thaivalappil F, Thamu B, Thickett D, Thomas C, Thomas S, Thomas AK, Thomas-Woods T, Thompson T, Thompson AAR, Thornton T, Tilley J, Tinker N, Tiongson GF, Tobin M, Tomlinson J, Tong C, Touyz R, Tripp KA, Tunnicliffe E, Turnbull A, Turner E, Turner S, Turner V, Turner K, Turney S, Turtle L, Turton H, Ugoji J, Ugwuoke R, Upthegrove R, Valabhji J, Ventura M, Vere J, Vickers C, Vinson B, Wade E, Wade P, Wainwright T, Wajero LO, Walder S, Walker S, Walker S, Wall E, Wallis T, Walmsley S, Walsh JA, Walsh S, Warburton L, Ward TJC, Warwick K, Wassall H, Waterson S, Watson E, Watson L, Watson J, Welch C, Welch H, Welsh B, Wessely S, West S, Weston H, Wheeler H, White S, Whitehead V, Whitney J, Whittaker S, Whittam B, Whitworth V, Wight A, Wild J, Wilkins M, Wilkinson D, Williams N, Williams N, Williams J, Williams-Howard SA, Willicombe M, Willis G, Willoughby J, Wilson A, Wilson D, Wilson I, Window N, Witham M, Wolf-Roberts R, Wood C, Woodhead F, Woods J, Wormleighton J, Worsley J, Wraith D, Wrey Brown C, Wright C, Wright L, Wright S, Wyles J, Wynter I, Xu M, Yasmin N, Yasmin S, Yates T, Yip KP, Young B, Young S, Young A, Yousuf AJ, Zawia A, Zeidan L, Zhao B, Zongo O. Clinical characteristics with inflammation profiling of long COVID and association with 1-year recovery following hospitalisation in the UK: a prospective observational study. Lancet Respir Med 2022; 10:761-775. [PMID: 35472304 PMCID: PMC9034855 DOI: 10.1016/s2213-2600(22)00127-8] [Citation(s) in RCA: 144] [Impact Index Per Article: 72.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 03/23/2022] [Accepted: 03/31/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND No effective pharmacological or non-pharmacological interventions exist for patients with long COVID. We aimed to describe recovery 1 year after hospital discharge for COVID-19, identify factors associated with patient-perceived recovery, and identify potential therapeutic targets by describing the underlying inflammatory profiles of the previously described recovery clusters at 5 months after hospital discharge. METHODS The Post-hospitalisation COVID-19 study (PHOSP-COVID) is a prospective, longitudinal cohort study recruiting adults (aged ≥18 years) discharged from hospital with COVID-19 across the UK. Recovery was assessed using patient-reported outcome measures, physical performance, and organ function at 5 months and 1 year after hospital discharge, and stratified by both patient-perceived recovery and recovery cluster. Hierarchical logistic regression modelling was performed for patient-perceived recovery at 1 year. Cluster analysis was done using the clustering large applications k-medoids approach using clinical outcomes at 5 months. Inflammatory protein profiling was analysed from plasma at the 5-month visit. This study is registered on the ISRCTN Registry, ISRCTN10980107, and recruitment is ongoing. FINDINGS 2320 participants discharged from hospital between March 7, 2020, and April 18, 2021, were assessed at 5 months after discharge and 807 (32·7%) participants completed both the 5-month and 1-year visits. 279 (35·6%) of these 807 patients were women and 505 (64·4%) were men, with a mean age of 58·7 (SD 12·5) years, and 224 (27·8%) had received invasive mechanical ventilation (WHO class 7-9). The proportion of patients reporting full recovery was unchanged between 5 months (501 [25·5%] of 1965) and 1 year (232 [28·9%] of 804). Factors associated with being less likely to report full recovery at 1 year were female sex (odds ratio 0·68 [95% CI 0·46-0·99]), obesity (0·50 [0·34-0·74]) and invasive mechanical ventilation (0·42 [0·23-0·76]). Cluster analysis (n=1636) corroborated the previously reported four clusters: very severe, severe, moderate with cognitive impairment, and mild, relating to the severity of physical health, mental health, and cognitive impairment at 5 months. We found increased inflammatory mediators of tissue damage and repair in both the very severe and the moderate with cognitive impairment clusters compared with the mild cluster, including IL-6 concentration, which was increased in both comparisons (n=626 participants). We found a substantial deficit in median EQ-5D-5L utility index from before COVID-19 (retrospective assessment; 0·88 [IQR 0·74-1·00]), at 5 months (0·74 [0·64-0·88]) to 1 year (0·75 [0·62-0·88]), with minimal improvements across all outcome measures at 1 year after discharge in the whole cohort and within each of the four clusters. INTERPRETATION The sequelae of a hospital admission with COVID-19 were substantial 1 year after discharge across a range of health domains, with the minority in our cohort feeling fully recovered. Patient-perceived health-related quality of life was reduced at 1 year compared with before hospital admission. Systematic inflammation and obesity are potential treatable traits that warrant further investigation in clinical trials. FUNDING UK Research and Innovation and National Institute for Health Research.
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Ryan C, Kendall V, Hildage J, Orr A, Magalhaes AO, Mitchell J. Taking cystic fibrosis physiotherapy homecare into the virtual era. Physiotherapy 2022. [DOI: 10.1016/j.physio.2021.12.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Courand P, Bozio A, Ninet J, Boussel L, Bakloul M, Galoin-Bertail C, Metton O, Mitchell J, Perouse De Montclos T, Walton C, Di-Filippo S. Diagnosis and treatment of anomalous aortic origin of coronary artery: A twenty-year retrospective study of experience and decision-making in children and young adults. Archives of Cardiovascular Diseases Supplements 2022. [DOI: 10.1016/j.acvdsp.2021.09.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Gatto GJ, Krovi A, Li L, Massud I, Holder A, Gary J, Mills P, Mitchell J, Luecke E, Demkovich ZR, Heneine W, García-Lerma JG, Marzinke MA, Brand RM, Dobard CW, Johnson LM, Van Der Straten A. Comparative Pharmacokinetics and Local Tolerance of Tenofovir Alafenamide (TAF) From Subcutaneous Implant in Rabbits, Dogs, and Macaques. Front Pharmacol 2022; 13:923954. [PMID: 35928266 PMCID: PMC9343794 DOI: 10.3389/fphar.2022.923954] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 06/16/2022] [Indexed: 01/18/2023] Open
Abstract
The administration of antiretrovirals (ARVs) for HIV pre-exposure prophylaxis (PrEP) is highly efficacious and may benefit from new long-acting (LA) drug delivery approaches. This paper describes a subcutaneous, reservoir-style implant for the LA delivery of tenofovir alafenamide (TAF) and documents the preclinical assessment of implant safety and pharmacokinetics (PK) in New Zealand White (NZW) rabbits (3 groups of n = 5), beagle dogs (2 groups of n = 6), and rhesus macaques (2 groups of n = 3). Placebo implants were placed in rabbits (n = 10) and dogs (n = 12). Implant parameters, including selection of the TAF form, choice of excipient, and PCL formulation were tuned to achieve targeted concentrations of the active anabolite of TAF, tenofovir diphosphate (TFV-DP), within peripheral blood mononuclear cells (PBMCs) and mucosal tissues relevant to HIV transmission. Sustained concentrations of TFV-DP in PBMCs over 100 fmol/106 cells were achieved in all animal species indicating that the implants effectively delivered TAF for 3-6 months. Unlike placebo implants without TAF, all active implants resulted in local adverse events (AEs) proximal to the implant ranging in severity from mild to moderate and included dermal inflammation and necrosis across all species. Despite these AEs, the implant performed as designed and achieved a constant drug release profile, supporting the continued development of this drug delivery platform.
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Affiliation(s)
- G J Gatto
- RTI International, Research Triangle Park, NC, United States
| | - A Krovi
- RTI International, Research Triangle Park, NC, United States
| | - L Li
- RTI International, Research Triangle Park, NC, United States
| | - I Massud
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - A Holder
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - J Gary
- Neuropathology, StageBio, Frederick, MD, United States
| | - P Mills
- Department of Comparative Medicine, Tulane University, New Orleans, LA, United States
| | - J Mitchell
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - E Luecke
- RTI International, Research Triangle Park, NC, United States
| | - Z R Demkovich
- RTI International, Research Triangle Park, NC, United States
| | - W Heneine
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - J G García-Lerma
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - M A Marzinke
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, United States.,Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - R M Brand
- Department of Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States.,Magee-Womens Research Institute, University of Pittsburgh, Pittsburgh, PA, United States
| | - C W Dobard
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - L M Johnson
- RTI International, Research Triangle Park, NC, United States
| | - A Van Der Straten
- Department of Medicine, Center for AIDS Prevention Studies (CAPS), University of California, San Francisco, CA, United States.,ASTRA Consulting, Kensington, CA, United States
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Atkins B, Matthews S, Walton N, Mitchell J, Battaglia T, Muir T, Jennings GLR, Buttery AK. Development and uptake of the National Heart Foundation of Australia Smart Heart Guideline App. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.3113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Many organisations have developed Smartphone mobile applications (apps) to improve access and uptake of clinical guidelines, including the European Society of Cardiology and the American Heart Foundation. The National Heart Foundation of Australia publish clinical guidelines in collaboration with the Cardiac Society of Australia and New Zealand. We aimed to develop an app for three national guidelines: 1) the Australian clinical guidelines for the prevention and detection of atrial fibrillation 2018; 2) the Australian clinical guidelines for the detection and management of heart failure in Australia 2018; and 3) the Australian clinical guidelines for the management of acute coronary syndromes 2016.
Purpose
To develop a mobile app for Australian health professionals to improve access and uptake of national cardiac clinical guidelines.
Methods
A national health professional mobile app online survey was developed and distributed in 2017. Survey items included the frequency of searching for information about the prevention or management of cardiovascular disease, the methods of searching, and the likelihood of using an Australian-specific mobile app to access clinical guidelines. Following analysis of survey responses, a software developer was contracted to develop the app, which included user-testing. The Smart Heart Guidelines App was registered with the regulatory body in Australia, the Therapeutic Goods Administration, and made freely available from October 2019 on iOS and Android operating systems. The app was promoted using electronic direct mail, social media techniques (Twitter and LinkedIn), on our organisation's website and via printed flyers and materials at regional and national event stands at conferences. Data from the Apple App Store was analysed between 1 October 2019 – 1 October 2020 to evaluate app use.
Results
The health professional survey (respondents n=504; nurses 39%, allied health professionals 26%; GP/cardiologist 9%; researcher 8%; other 18%) showed most (n=447; 89%) reported accessing the Heart Foundation's resources electronically. The majority (n=355; 70%) reported they would be likely to use an Australian-specific app. Data from the Apple App Store indicated over 30,300 impressions (the number of times the Smart Heart App appeared in an App Store search) during the first year the app was available. This resulted in approximately 4,400 app downloads, with consistent “search-to-download rates” throughout the year (monthly average rate 22%). Of the downloads, 3,200 (82%) were a direct result of searching for the Smart Heart App, indicating promotional activities were effective.
Conclusion
Development of the Smart Heart Guideline App in Australia was indicated by health professionals to improve access to national cardiac clinical guidelines. Consistent app downloads and use during the first-year support further research, development, promotion, and evaluation of the app.
Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): The National Heart Foundation of Australia
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Affiliation(s)
- B Atkins
- The National Heart Foundation of Australia, Melbourne, Australia
| | - S Matthews
- The National Heart Foundation of Australia, Melbourne, Australia
| | - N Walton
- The National Heart Foundation of Australia, Melbourne, Australia
| | - J Mitchell
- The National Heart Foundation of Australia, Melbourne, Australia
| | - T Battaglia
- The National Heart Foundation of Australia, Melbourne, Australia
| | - T Muir
- The National Heart Foundation of Australia, Melbourne, Australia
| | - G L R Jennings
- The National Heart Foundation of Australia, Melbourne, Australia
| | - A K Buttery
- The National Heart Foundation of Australia, Melbourne, Australia
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Mollan SP, Wakerley BR, Alimajstorovic Z, Mitchell J, Ottridge R, Yiangou A, Thaller M, Gupta A, Grech O, Lavery G, Brock K, Sinclair AJ. Intracranial pressure directly predicts headache morbidity in idiopathic intracranial hypertension. J Headache Pain 2021; 22:118. [PMID: 34620087 PMCID: PMC8499560 DOI: 10.1186/s10194-021-01321-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 09/01/2021] [Indexed: 01/03/2023] Open
Abstract
Objective Headache is the predominant disabler in idiopathic intracranial hypertension (IIH). The aim was to characterise headache and investigate the association with intracranial pressure. Methods IIH:WT was a randomised controlled parallel group multicentre trial in the United Kingdom investigating weight management methods in IIH. Participants with active IIH (evidenced by papilloedema) and a body mass index (BMI) ≥35 kg/m2 were recruited. At baseline, 12 months and 24 months headache characteristics and quality of life outcome measures were collected and lumbar puncture measurements were performed. Results Sixty-six women with active IIH were included with a mean age of 32.0 years (SD ± 7.8), and mean body mass index of 43.9 ± 7.0 kg/m2. The headache phenotype was migraine-like in 90%. Headache severity correlated with ICP at baseline (r = 0.285; p = 0.024); change in headache severity and monthly headache days correlated with change in ICP at 12 months (r = 0.454, p = 0.001 and r = 0.419, p = 0.002 respectively). Cutaneous allodynia was significantly correlated with ICP at 12 months. (r = 0.479, p < 0.001). Boot strap analysis noted a positive association between ICP at 12 and 24 months and enabled prediction of both change in headache severity and monthly headache days. ICP was associated with significant improvements in quality of life (SF-36). Conclusions We demonstrate a positive relationship between ICP and headache and cutaneous allodynia, which has not been previously reported in IIH. Those with the greatest reduction in ICP over 12 months had the greatest reduction in headache frequency and severity; this was associated with improvement of quality of life measures. Trial registration This work provides Class IIa evidence of the association of raised intracranial pressure and headache. ClinicalTrials.gov number, NCT02124486. Supplementary Information The online version contains supplementary material available at 10.1186/s10194-021-01321-8.
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Affiliation(s)
- S P Mollan
- Birmingham Neuro-Ophthalmology Unit, University Hospitals Birmingham, Birmingham, UK
| | - B R Wakerley
- University of Birmingham, Metabolic Neurology, Institute of Metabolism and Systems Research, Birmingham, UK.,Department of Neurology, University Hospitals Birmingham, Birmingham, UK
| | - Z Alimajstorovic
- University of Birmingham, Metabolic Neurology, Institute of Metabolism and Systems Research, Birmingham, UK
| | - J Mitchell
- University of Birmingham, Metabolic Neurology, Institute of Metabolism and Systems Research, Birmingham, UK.,Department of Neurology, University Hospitals Birmingham, Birmingham, UK
| | - R Ottridge
- University of Birmingham College of Medical and Dental Sciences, Birmingham, UK
| | - A Yiangou
- University of Birmingham, Metabolic Neurology, Institute of Metabolism and Systems Research, Birmingham, UK.,Department of Neurology, University Hospitals Birmingham, Birmingham, UK
| | - M Thaller
- University of Birmingham, Metabolic Neurology, Institute of Metabolism and Systems Research, Birmingham, UK.,Department of Neurology, University Hospitals Birmingham, Birmingham, UK
| | - A Gupta
- University of Birmingham College of Medical and Dental Sciences, Birmingham, UK
| | - O Grech
- University of Birmingham, Metabolic Neurology, Institute of Metabolism and Systems Research, Birmingham, UK
| | - G Lavery
- University of Birmingham, Metabolic Neurology, Institute of Metabolism and Systems Research, Birmingham, UK
| | - K Brock
- Birmingham Clinical Trials Unit, University of Birmingham, Birmingham, UK
| | - A J Sinclair
- University of Birmingham, Metabolic Neurology, Institute of Metabolism and Systems Research, Birmingham, UK. .,Department of Neurology, University Hospitals Birmingham, Birmingham, UK.
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Yee LM, McGee P, Bailit JL, Wapner RJ, Varner MW, Thorp JM, Caritis SN, Prasad M, Tita AT, Saade GR, Sorokin Y, Rouse DJ, Blackwell SC, Tolosa JE, Mallett G, Grobman W, Ramos-Brinson M, Roy A, Stein L, Campbell P, Collins C, Jackson N, Dinsmoor M, Senka J, Paychek K, Peaceman A, Talucci M, Zylfijaj M, Reid Z, Leed R, Benson J, Forester S, Kitto C, Davis S, Falk M, Perez C, Hill K, Sowles A, Postma J, Alexander S, Andersen G, Scott V, Morby V, Jolley K, Miller J, Berg B, Dorman K, Mitchell J, Kaluta E, Clark K, Spicer K, Timlin S, Wilson K, Moseley L, Leveno K, Santillan M, Price J, Buentipo K, Bludau V, Thomas T, Fay L, Melton C, Kingsbery J, Benezue R, Simhan H, Bickus M, Fischer D, Kamon T, DeAngelis D, Mercer B, Milluzzi C, Dalton W, Dotson T, McDonald P, Brezine C, McGrail A, Latimer C, Guzzo L, Johnson F, Gerwig L, Fyffe S, Loux D, Frantz S, Cline D, Wylie S, Iams J, Wallace M, Northen A, Grant J, Colquitt C, Rouse D, Andrews W, Moss J, Salazar A, Acosta A, Hankins G, Hauff N, Palmer L, Lockhart P, Driscoll D, Wynn L, Sudz C, Dengate D, Girard C, Field S, Breault P, Smith F, Annunziata N, Allard D, Silva J, Gamage M, Hunt J, Tillinghast J, Corcoran N, Jimenez M, Ortiz F, Givens P, Rech B, Moran C, Hutchinson M, Spears Z, Carreno C, Heaps B, Zamora G, Seguin J, Rincon M, Snyder J, Farrar C, Lairson E, Bonino C, Smith W, Beach K, Van Dyke S, Butcher S, Thom E, Rice M, Zhao Y, Momirova V, Palugod R, Reamer B, Larsen M, Spong C, Tolivaisa S, VanDorsten J. Differences in obstetrical care and outcomes associated with the proportion of the obstetrician's shift completed. Am J Obstet Gynecol 2021; 225:430.e1-430.e11. [PMID: 33812810 DOI: 10.1016/j.ajog.2021.03.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 03/14/2021] [Accepted: 03/26/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Understanding and improving obstetrical quality and safety is an important goal of professional societies, and many interventions such as checklists, safety bundles, educational interventions, or other culture changes have been implemented to improve the quality of care provided to obstetrical patients. Although many factors contribute to delivery decisions, a reduced workload has addressed how provider issues such as fatigue or behaviors surrounding impending shift changes may influence the delivery mode and outcomes. OBJECTIVE The objective was to assess whether intrapartum obstetrical interventions and adverse outcomes differ based on the temporal proximity of the delivery to the attending's shift change. STUDY DESIGN This was a secondary analysis from a multicenter obstetrical cohort in which all patients with cephalic, singleton gestations who attempted vaginal birth were eligible for inclusion. The primary exposure used to quantify the relationship between the proximity of the provider to their shift change and a delivery intervention was the ratio of time from the most recent attending shift change to vaginal delivery or decision for cesarean delivery to the total length of the shift. Ratios were used to represent the proportion of time completed in the shift by normalizing for varying shift lengths. A sensitivity analysis restricted to patients who were delivered by physicians working 12-hour shifts was performed. Outcomes chosen included cesarean delivery, episiotomy, third- or fourth-degree perineal laceration, 5-minute Apgar score of <4, and neonatal intensive care unit admission. Chi-squared tests were used to evaluate outcomes based on the proportion of the attending's shift completed. Adjusted and unadjusted logistic models fitting a cubic spline (when indicated) were used to determine whether the frequency of outcomes throughout the shift occurred in a statistically significant, nonlinear pattern RESULTS: Of the 82,851 patients eligible for inclusion, 47,262 (57%) had ratio data available and constituted the analyzable sample. Deliveries were evenly distributed throughout shifts, with 50.6% taking place in the first half of shifts. There were no statistically significant differences in the frequency of cesarean delivery, episiotomy, third- or fourth-degree perineal lacerations, or 5-minute Apgar scores of <4 based on the proportion of the shift completed. The findings were unchanged when evaluated with a cubic spline in unadjusted and adjusted logistic models. Sensitivity analyses performed on the 22.2% of patients who were delivered by a physician completing a 12-hour shift showed similar findings. There was a small increase in the frequency of neonatal intensive care unit admissions with a greater proportion of the shift completed (adjusted P=.009), but the findings did not persist in the sensitivity analysis. CONCLUSION Clinically significant differences in obstetrical interventions and outcomes do not seem to exist based on the temporal proximity to the attending physician's shift change. Future work should attempt to directly study unit culture and provider fatigue to further investigate opportunities to improve obstetrical quality of care, and additional studies are needed to corroborate these findings in community settings.
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Adler C, Ahammed Z, Allgower C, Amonett J, Anderson BD, Anderson M, Averichev GS, Balewski J, Barannikova O, Barnby LS, Baudot J, Bekele S, Belaga VV, Bellwied R, Berger J, Bichsel H, Billmeier A, Bland LC, Blyth CO, Bonner BE, Boucham A, Brandin A, Bravar A, Cadman RV, Caines H, Calderón de la Barca Sánchez M, Cardenas A, Carroll J, Castillo J, Castro M, Cebra D, Chaloupka P, Chattopadhyay S, Chen Y, Chernenko SP, Cherney M, Chikanian A, Choi B, Christie W, Coffin JP, Cormier TM, Cramer JG, Crawford HJ, Csanád M, Deng WS, Derevschikov AA, Didenko L, Dietel T, Draper JE, Dunin VB, Dunlop JC, Eckardt V, Efimov LG, Emelianov V, Engelage J, Eppley G, Erazmus B, Fachini P, Faine V, Filimonov K, Finch E, Fisyak Y, Flierl D, Foley KJ, Fu J, Gagliardi CA, Gagunashvili N, Gans J, Gaudichet L, Germain M, Geurts F, Ghazikhanian V, Grachov O, Grigoriev V, Guedon M, Gushin E, Hallman TJ, Hardtke D, Harris JW, Henry TW, Heppelmann S, Herston T, Hippolyte B, Hirsch A, Hjort E, Hoffmann GW, Horsley M, Huang HZ, Humanic TJ, Igo G, Ishihara A, Ivanshin YI, Jacobs P, Jacobs WW, Janik M, Johnson I, Jones PG, Judd EG, Kaneta M, Kaplan M, Keane D, Kiryluk J, Kisiel A, Klay J, Klein SR, Klyachko A, Konstantinov AS, Kopytine M, Kotchenda L, Kovalenko AD, Kramer M, Kravtsov P, Krueger K, Kuhn C, Kulikov AI, Kunde GJ, Kunz CL, Kutuev RK, Kuznetsov AA, Lakehal-Ayat L, Lamont MAC, Landgraf JM, Lange S, Lansdell CP, Lasiuk B, Laue F, Lebedev A, Lednický R, Leontiev VM, LeVine MJ, Li Q, Lindenbaum SJ, Lisa MA, Liu F, Liu L, Liu Z, Liu QJ, Ljubicic T, Llope WJ, LoCurto G, Long H, Longacre RS, Lopez-Noriega M, Love WA, Ludlam T, Lynn D, Ma J, Ma R, Majka R, Margetis S, Markert C, Martin L, Marx J, Matis HS, Matulenko YA, McShane TS, Meissner F, Melnick Y, Meschanin A, Messer M, Miller ML, Milosevich Z, Minaev NG, Mitchell J, Moiseenko VA, Moore CF, Morozov V, de Moura MM, Munhoz MG, Nelson JM, Nevski P, Niida T, Nikitin VA, Nogach LV, Norman B, Nurushev SB, Odyniec G, Ogawa A, Okorokov V, Oldenburg M, Olson D, Paic G, Pandey SU, Panebratsev Y, Panitkin SY, Pavlinov AI, Pawlak T, Perevoztchikov V, Peryt W, Petrov VA, Planinic M, Pluta J, Porile N, Porter J, Poskanzer AM, Potrebenikova E, Prindle D, Pruneau C, Putschke J, Rai G, Rakness G, Ravel O, Ray RL, Razin SV, Reichhold D, Reid JG, Retiere F, Ridiger A, Ritter HG, Roberts JB, Rogachevski OV, Romero JL, Rose A, Roy C, Rykov V, Sakrejda I, Salur S, Sandweiss J, Saulys AC, Savin I, Schambach J, Scharenberg RP, Schmitz N, Schroeder LS, Schüttauf A, Schweda K, Seger J, Seliverstov D, Seyboth P, Shahaliev E, Shestermanov KE, Shimanskii SS, Shvetcov VS, Skoro G, Smirnov N, Snellings R, Sorensen P, Sowinski J, Spinka HM, Srivastava B, Stephenson EJ, Stock R, Stolpovsky A, Strikhanov M, Stringfellow B, Struck C, Suaide AAP, Sugarbaker E, Suire C, Šumbera M, Surrow B, Symons TJM, Szanto de Toledo A, Szarwas P, Tai A, Takahashi J, Tang AH, Thomas JH, Thompson M, Tikhomirov V, Todoroki T, Tokarev M, Tonjes MB, Trainor TA, Trentalange S, Tribble RE, Trofimov V, Tsai O, Ullrich T, Underwood DG, Van Buren G, VanderMolen AM, Vasilevski IM, Vasiliev AN, Vigdor SE, Voloshin SA, Wang F, Ward H, Watson JW, Wells R, Westfall GD, Whitten C, Wieman H, Willson R, Wissink SW, Witt R, Wood J, Xu N, Xu Z, Yakutin AE, Yamamoto E, Yang J, Yepes P, Yurevich VI, Zanevski YV, Zborovský I, Zhang H, Zhang WM, Zoulkarneev R, Zubarev AN. Erratum: Azimuthal Anisotropy of K_{S}^{0} and Λ+Λ[over ¯] Production at Midrapidity from Au+Au Collisions at sqrt[s]_{NN}=130 GeV [Phys. Rev. Lett. 89, 132301 (2002)]. Phys Rev Lett 2021; 127:089901. [PMID: 34477449 DOI: 10.1103/physrevlett.127.089901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Indexed: 06/13/2023]
Abstract
This corrects the article DOI: 10.1103/PhysRevLett.89.132301.
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Adams J, Adler C, Aggarwal MM, Ahammed Z, Amonett J, Anderson BD, Anderson M, Arkhipkin D, Averichev GS, Badyal SK, Balewski J, Barannikova O, Barnby LS, Baudot J, Bekele S, Belaga VV, Bellwied R, Berger J, Bezverkhny BI, Bhardwaj S, Bhaskar P, Bhati AK, Bichsel H, Billmeier A, Bland LC, Blyth CO, Bonner BE, Botje M, Boucham A, Brandin A, Bravar A, Cadman RV, Cai XZ, Caines H, Calderón de la Barca Sánchez M, Carroll J, Castillo J, Castro M, Cebra D, Chaloupka P, Chattopadhyay S, Chen HF, Chen Y, Chernenko SP, Cherney M, Chikanian A, Choi B, Christie W, Coffin JP, Cormier TM, Cramer JG, Crawford HJ, Csanád M, Das D, Das S, Derevschikov AA, Didenko L, Dietel T, Dong WJ, Dong X, Draper JE, Du F, Dubey AK, Dunin VB, Dunlop JC, Dutta Majumdar MR, Eckardt V, Efimov LG, Emelianov V, Engelage J, Eppley G, Erazmus B, Estienne M, Fachini P, Faine V, Faivre J, Fatemi R, Filimonov K, Filip P, Finch E, Fisyak Y, Flierl D, Foley KJ, Fu J, Gagliardi CA, Gagunashvili N, Gans J, Ganti MS, Gaudichet L, Germain M, Geurts F, Ghazikhanian V, Ghosh P, Gonzalez JE, Grachov O, Grigoriev V, Gronstal S, Grosnick D, Guedon M, Guertin SM, Gupta A, Gushin E, Gutierrez TD, Hallman TJ, Hardtke D, Harris JW, Heinz M, Henry TW, Heppelmann S, Herston T, Hippolyte B, Hirsch A, Hjort E, Hoffmann GW, Horsley M, Huang HZ, Huang SL, Humanic TJ, Igo G, Ishihara A, Jacobs P, Jacobs WW, Janik M, Jiang H, Johnson I, Jones PG, Judd EG, Kabana S, Kaneta M, Kaplan M, Keane D, Khodyrev VY, Kiryluk J, Kisiel A, Klay J, Klein SR, Klyachko A, Koetke DD, Kollegger T, Kopytine M, Kotchenda L, Kovalenko AD, Kramer M, Kravtsov P, Kravtsov VI, Krueger K, Kuhn C, Kulikov AI, Kumar A, Kunde GJ, Kunz CL, Kutuev RK, Kuznetsov AA, Lamont MAC, Landgraf JM, Lange S, Lansdell CP, Lasiuk B, Laue F, Lauret J, Lebedev A, Lednický R, LeVine MJ, Li C, Li Q, Lindenbaum SJ, Lisa MA, Liu F, Liu L, Liu Z, Liu QJ, Ljubicic T, Llope WJ, Long H, Longacre RS, Lopez-Noriega M, Love WA, Ludlam T, Lynn D, Ma J, Ma R, Ma YG, Magestro D, Mahajan S, Mangotra LK, Mahapatra DP, Majka R, Manweiler R, Margetis S, Markert C, Martin L, Marx J, Matis HS, Matulenko YA, McShane TS, Meissner F, Melnick Y, Meschanin A, Messer M, Miller ML, Milosevich Z, Minaev NG, Mironov C, Mishra D, Mitchell J, Mohanty B, Molnar L, Moore CF, Mora-Corral MJ, Morozov DA, Morozov V, de Moura MM, Munhoz MG, Nandi BK, Nayak SK, Nayak TK, Nelson JM, Nevski P, Niida T, Nikitin VA, Nogach LV, Norman B, Nurushev SB, Odyniec G, Ogawa A, Okorokov V, Oldenburg M, Olson D, Paic G, Pandey SU, Pal SK, Panebratsev Y, Panitkin SY, Pavlinov AI, Pawlak T, Perevoztchikov V, Perkins C, Peryt W, Petrov VA, Phatak SC, Picha R, Planinic M, Pluta J, Porile N, Porter J, Poskanzer AM, Potekhin M, Potrebenikova E, Potukuchi BVKS, Prindle D, Pruneau C, Putschke J, Rai G, Rakness G, Raniwala R, Raniwala S, Ravel O, Ray RL, Razin SV, Reichhold D, Reid JG, Renault G, Retiere F, Ridiger A, Ritter HG, Roberts JB, Rogachevski OV, Romero JL, Rose A, Roy C, Ruan LJ, Sahoo R, Sakrejda I, Salur S, Sandweiss J, Savin I, Schambach J, Scharenberg RP, Schmitz N, Schroeder LS, Schweda K, Seger J, Seliverstov D, Seyboth P, Shahaliev E, Shao M, Sharma M, Shestermanov KE, Shimanskii SS, Singaraju RN, Simon F, Skoro G, Smirnov N, Snellings R, Sood G, Sorensen P, Sowinski J, Spinka HM, Srivastava B, Stanislaus S, Stock R, Stolpovsky A, Strikhanov M, Stringfellow B, Struck C, Suaide AAP, Sugarbaker E, Suire C, Šumbera M, Surrow B, Symons TJM, Szanto de Toledo A, Szarwas P, Tai A, Takahashi J, Tang AH, Thein D, Thomas JH, Tikhomirov V, Todoroki T, Tokarev M, Tonjes MB, Trainor TA, Trentalange S, Tribble RE, Trivedi MD, Trofimov V, Tsai O, Ullrich T, Underwood DG, Van Buren G, VanderMolen AM, Vasiliev AN, Vasiliev M, Vigdor SE, Viyogi YP, Voloshin SA, Waggoner W, Wang F, Wang G, Wang XL, Wang ZM, Ward H, Watson JW, Wells R, Westfall GD, Whitten C, Wieman H, Willson R, Wissink SW, Witt R, Wood J, Wu J, Xu N, Xu Z, Xu ZZ, Yamamoto E, Yepes P, Yurevich VI, Zanevski YV, Zborovský I, Zhang H, Zhang WM, Zhang ZP, Żołnierczuk PA, Zoulkarneev R, Zoulkarneeva J, Zubarev AN. Erratum: Azimuthal Anisotropy at the Relativistic Heavy Ion Collider: The First and Fourth Harmonics [Phys. Rev. Lett. 92, 062301 (2004)]. Phys Rev Lett 2021; 127:069901. [PMID: 34420354 DOI: 10.1103/physrevlett.127.069901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Indexed: 06/13/2023]
Abstract
This corrects the article DOI: 10.1103/PhysRevLett.92.062301.
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O'Sullivan O, Allsopp L, Mitchell J, Price L, Tourle K, Ellis H. Review of neurological rehabilitation for Multiple Sclerosis in the British Military. BMJ Mil Health 2021; 168:324-328. [PMID: 34253640 DOI: 10.1136/bmjmilitary-2021-001852] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 06/07/2021] [Indexed: 01/09/2023]
Abstract
Multiple sclerosis (MS) is a progressive neurological disorder, classically presenting in working age adults, including those in the Armed Forces. The Defence Medical Rehabilitation Centre (DMRC) Stanford Hall offers vocationally focused neurorehabilitation services for service personnel (SP) with MS, with the goal to minimise disability, maximise independence and remain able to work.This paper has two aims. First, it briefly provides a clinical update of MS, focusing on pathology, presentation, diagnosis and management. Finally, it will describe the role of DMRC and data from the last decade in the management of MS.Our findings suggest not all SP with MS are being referred to DMRC, and some of those who do have significant delays, potentially impacting on patient support, symptom management and occupational outcomes. It is hoped that this paper will improve awareness and recognition of MS for Armed Forces personnel.
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Affiliation(s)
- Oliver O'Sullivan
- Academic Department of Military Rehabilitation, DMRC Stanford Hall, Loughborough, UK .,Headquarters Army Medical Services (HQ AMS), Camberley, UK
| | - L Allsopp
- Neuro-Rehabilitation Department, DMRC Stanford Hall, Loughborough, UK
| | - J Mitchell
- Academic Department of Military Rehabilitation, DMRC Stanford Hall, Loughborough, UK.,Metabolic Neurology, University of Birmingham Institute of Metabolism and Systems Research, Birmingham, UK
| | - L Price
- Neuro-Rehabilitation Department, DMRC Stanford Hall, Loughborough, UK
| | - K Tourle
- Neuro-Rehabilitation Department, DMRC Stanford Hall, Loughborough, UK
| | - H Ellis
- Neuro-Rehabilitation Department, DMRC Stanford Hall, Loughborough, UK
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McMullan T, Nailon B, McLaren D, Keough W, Law A, Berger T, Ronaldson T, Mitchell J. PO-0231 Using PSA Kinetics to Predict 5-yr Biochemical Failure in Intermediate-Risk Prostate Cancer Patients. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)06390-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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McMullan T, Nailon B, McLaren D, Keough W, Law A, Berger T, Ronaldson T, Mitchell J. PP-0157 Long-term Outcomes of Prostate Cancer Patients treated with Low Dose Rate Brachytherapy. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)06449-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Lee J, Chaft J, Nicholas A, Patterson A, Waqar S, Toloza E, Haura E, Raz D, Reckamp K, Merritt R, Owen D, Finley D, Mcnamee C, Blasberg J, Garon E, Mitchell J, Doebele R, Baciewicz F, Nagasaka M, Pass H, Schulze K, Phan S, Johnson A, Bunn P, Johnson B, Kris M, Kwiatkowski D, Wistuba I, Carbone D, Rusch V. PS01.05 Surgical and Clinical Outcomes With Neoadjuvant Atezolizumab in Resectable Stage IB–IIIB NSCLC: LCMC3 Trial Primary Analysis. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.320] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Vaquette C, Mitchell J, Fernandez-Medina T, Kumar S, Ivanovski S. Resorbable additively manufactured scaffold imparts dimensional stability to extraskeletally regenerated bone. Biomaterials 2021; 269:120671. [PMID: 33493771 DOI: 10.1016/j.biomaterials.2021.120671] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 01/03/2021] [Accepted: 01/05/2021] [Indexed: 12/19/2022]
Abstract
Dimensionally stable vertical bone regeneration outside of the existing bony envelope is a major challenge in the field of orofacial surgery. In this study, we demonstrate that a highly porous, resorbable scaffold fabricated using additive manufacturing techniques enables reproducible extra-skeletal bone formation and prevents bone resorption. An additively manufactured medical grade polycaprolactone (mPCL) biphasic scaffold mimicking the architecture of the jaw bone, consisting of a 3D-printed outer shell overlying an inner highly porous melt electrowritten scaffold, was assessed for its ability to support dimensionally stable bone regeneration in an extraskeletal ovine calvarial model. To investigate bone formation capacity (stage 1), 7 different constructs placed under a protective dome were assessed 8 weeks post-implantation: Empty control, Biphasic scaffold with hydrogel (PCL-Gel), PCL-Gel with 75 or 150 μg of BMP-2 (PCL-BMP-75 and PCL-BMP-150), hydrogel only (Gel), Gel containing 75 or 150 μg of BMP-2 (Gel-BMP-75 and Gel-BMP-150). To assess dimensional stability (stage 2), in a separate cohort, 5 animals were similarly implanted with 2 samples of each of the Gel-BMP-150 and PCL-BMP-150 groups, and after 8 weeks of healing, the protective domes were removed and titanium implants were placed in the regenerated bone and allowed to heal for a further 8 weeks. Bone formation and osseointegration were assessed using micro-computed tomography, histology and histomorphometry. In stage 1, enhanced bone formation was found in the BMP-2 containing groups, especially the PCL-BMP constructs whereby regeneration of full bone height was achieved in a reproducible manner. There was no significant bone volume increase with the higher dose of BMP-2. In the dimensional stability assessment (stage 2), after the rtemoval of the protective dome, the biphasic scaffold prevented bone resorption whereas in the absence of the scaffold, the bone previously formed in the hydrogel underwent extensive resorption. This was attributed to the space maintenance properties and dimensional stability of the biphasic scaffold. Titanium implants osseointegrated into the newly formed bone within the biphasic scaffolds. In conclusion, additively manufactured biphasic scaffolds functionalized with BMP-2 facilitated dimensionally stable bone regeneration that supported dental implant osseointegration.
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Affiliation(s)
- C Vaquette
- The University of Queensland, School of Dentistry, Herston, Queensland, Australia.
| | - J Mitchell
- The University of Queensland, School of Dentistry, Herston, Queensland, Australia.
| | - T Fernandez-Medina
- The University of Queensland, School of Dentistry, Herston, Queensland, Australia.
| | - S Kumar
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.
| | - S Ivanovski
- The University of Queensland, School of Dentistry, Herston, Queensland, Australia.
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Fordyce C, Hodgson N, McVean R, Waller I, Mitchell J, Gyte R, Jones A. P194 Implementation of a cystic fibrosis-specific virtual pulmonary rehab program. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01219-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Waller I, Daulby J, Langman H, Yarwood V, Mitchell J, Jones A, Green H. EPS1.06 A retrospective audit of home-based spirometry quality in a large UK adult cystic fibrosis centre. J Cyst Fibros 2021. [PMCID: PMC8192156 DOI: 10.1016/s1569-1993(21)01004-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Gordon N, Aggarwal V, Amos B, Buhler C, Huszar A, McKenzie J, Mitchell J, Moyen N, Mubangizi P, Leslie T. The UK Fleming Fund: Developing AMR surveillance capacity in low- and middle-income countries. Int J Infect Dis 2020. [DOI: 10.1016/j.ijid.2020.09.137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Burns D, Rosbottom K, Mitchell J. PO-1844: Service evaluation of a new bladder filling protocol for radical prostate radiotherapy. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01862-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Dermer E, Spahr A, Tran LT, Mirchi A, Pelletier F, Guerrero K, Ahmed S, Brais B, Braverman N, Buhas D, Chandratre S, Chenier S, Chrestian N, Desmeules M, Dilenge ME, Laflamme J, Larbrisseau A, Legault G, Lim KY, Maftei C, Major P, Malvey-Dorn E, Marois P, Mitchell J, Nadeau A, Osterman B, Paradis I, Pohl D, Reggin J, Riou E, Roedde G, Rossignol E, Sébire G, Shevell M, Srour M, Sylvain M, Tarnopolsky M, Venkateswaran S, Sullivan M, Bernard G. Stress in Parents of Children With Genetically Determined Leukoencephalopathies: A Pilot Study. J Child Neurol 2020; 35:901-907. [PMID: 32720856 DOI: 10.1177/0883073820938645] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Genetically determined leukoencephalopathies comprise a group of rare inherited white matter disorders. The majority are progressive diseases resulting in early death. We performed a cross-sectional pilot study including 55 parents from 36 families to assess the level of stress experienced by parents of patients with genetically determined leukoencephalopathies, aged 1 month to 12 years. Thirty-four mothers and 21 fathers completed the Parenting Stress Index-4th Edition. One demographic questionnaire was completed per family. Detailed clinical data was gathered on all patients. Statistical analysis was performed with total stress percentile score as the primary outcome. Mothers and fathers had significantly higher stress levels compared with the normative sample; 20% of parents had high levels of stress whereas 11% had clinically significant levels of stress. Mothers and fathers had comparable total stress percentile scores. We identified pediatric behavioral difficulties and gross motor function to be factors influencing stress in mothers. Our study is the first to examine parental stress in this population and highlights the need for parental support early in the disease course. In this pilot study, we demonstrated that using the Parenting Stress Index-4th Edition to assess stress levels in parents of patients with genetically determined leukoencephalopathies is feasible, leads to valuable and actionable results, and should be used in larger, prospective studies.
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Affiliation(s)
- E Dermer
- Department of Neurology and Neurosurgery, 54473McGill University, Montréal, Québec Canada.,Department of Pediatrics, 54473McGill University, Montréal, Québec Canada.,Department of Human Genetics, 54473McGill University, Montréal, Québec, Canada.,Department of Specialized Medicine, Division of Medical Genetics, 507266McGill University Health Centre, Montréal, Québec, Canada.,Child Health and Human Development Program, 507266Research Institute of the McGill University Health Center, Montréal, Québec, Canada.,E. Dermer and A. Spahr are co-first authors of this article
| | - A Spahr
- Department of Neurology and Neurosurgery, 54473McGill University, Montréal, Québec Canada.,Department of Pediatrics, 54473McGill University, Montréal, Québec Canada.,Department of Human Genetics, 54473McGill University, Montréal, Québec, Canada.,Department of Specialized Medicine, Division of Medical Genetics, 507266McGill University Health Centre, Montréal, Québec, Canada.,Child Health and Human Development Program, 507266Research Institute of the McGill University Health Center, Montréal, Québec, Canada.,E. Dermer and A. Spahr are co-first authors of this article
| | - L T Tran
- Department of Neurology and Neurosurgery, 54473McGill University, Montréal, Québec Canada.,Department of Pediatrics, 54473McGill University, Montréal, Québec Canada.,Department of Human Genetics, 54473McGill University, Montréal, Québec, Canada.,Department of Specialized Medicine, Division of Medical Genetics, 507266McGill University Health Centre, Montréal, Québec, Canada.,Child Health and Human Development Program, 507266Research Institute of the McGill University Health Center, Montréal, Québec, Canada
| | - A Mirchi
- Department of Neurology and Neurosurgery, 54473McGill University, Montréal, Québec Canada.,Department of Pediatrics, 54473McGill University, Montréal, Québec Canada.,Department of Human Genetics, 54473McGill University, Montréal, Québec, Canada.,Department of Specialized Medicine, Division of Medical Genetics, 507266McGill University Health Centre, Montréal, Québec, Canada.,Child Health and Human Development Program, 507266Research Institute of the McGill University Health Center, Montréal, Québec, Canada
| | - F Pelletier
- Department of Neurology and Neurosurgery, 54473McGill University, Montréal, Québec Canada.,Department of Pediatrics, 54473McGill University, Montréal, Québec Canada.,Department of Human Genetics, 54473McGill University, Montréal, Québec, Canada.,Department of Specialized Medicine, Division of Medical Genetics, 507266McGill University Health Centre, Montréal, Québec, Canada.,Child Health and Human Development Program, 507266Research Institute of the McGill University Health Center, Montréal, Québec, Canada
| | - K Guerrero
- Department of Neurology and Neurosurgery, 54473McGill University, Montréal, Québec Canada.,Department of Pediatrics, 54473McGill University, Montréal, Québec Canada.,Department of Human Genetics, 54473McGill University, Montréal, Québec, Canada.,Department of Specialized Medicine, Division of Medical Genetics, 507266McGill University Health Centre, Montréal, Québec, Canada.,Child Health and Human Development Program, 507266Research Institute of the McGill University Health Center, Montréal, Québec, Canada
| | - S Ahmed
- 27364North Bay Regional Health Centre, North Bay, Ontario, Canada
| | - B Brais
- Department of Neurology and Neurosurgery, 54473McGill University, Montréal, Québec Canada.,Department of Human Genetics, 54473McGill University, Montréal, Québec, Canada
| | - N Braverman
- Child Health and Human Development Program, 507266Research Institute of the McGill University Health Center, Montréal, Québec, Canada
| | - D Buhas
- Department of Specialized Medicine, Division of Medical Genetics, 507266McGill University Health Centre, Montréal, Québec, Canada
| | - S Chandratre
- Department of Pediatric Neurology, 6397Oxford University Hospitals, Oxford, United Kingdom
| | - S Chenier
- Department of Medical Genetics, 7321University of Sherbrooke, Sherbrooke, Québec, Canada
| | - N Chrestian
- Division of Pediatric Neurology, 12369Centre Mère-Enfant Soleil du CHU de Québec-Université Laval, Québec, Canada.,Department of Pediatrics, 12369Centre Mère-Enfant Soleil du CHU de Québec-Université Laval, Québec, Canada
| | - M Desmeules
- Department of Pediatrics, Saguenay, Chicoutimi, Québec, Canada
| | - M E Dilenge
- Department of Neurology and Neurosurgery, 54473McGill University, Montréal, Québec Canada.,Department of Pediatrics, 54473McGill University, Montréal, Québec Canada
| | - J Laflamme
- Department of Pediatrics, 12369Centre Mère-Enfant Soleil du CHU de Québec-Université Laval, Québec, Canada
| | - A Larbrisseau
- Department of Pediatrics, 5622University of Montreal, Montréal, Québec, Canada.,Department of Neurology, CHU Saint-Justine, Montréal, Québec, Canada
| | - G Legault
- Department of Neurology and Neurosurgery, 54473McGill University, Montréal, Québec Canada.,Department of Human Genetics, 54473McGill University, Montréal, Québec, Canada
| | - K Y Lim
- Department of Pediatric Neurology, Providence Pediatric Neurology-St. Vincent, Portland, OR, USA
| | - C Maftei
- Department of Pediatrics, Division of Medical Genetics, CHU Saint-Justine, Montreal University, Montréal, Québec, Canada
| | - P Major
- Department of Pediatrics, 5622University of Montreal, Montréal, Québec, Canada
| | - E Malvey-Dorn
- Department of Pediatrics, All About Children Pediatrics Eden Prairie, St. Louis Park, MN, USA
| | - P Marois
- Department of Pediatrics, 5622University of Montreal, Montréal, Québec, Canada
| | - J Mitchell
- Child Health and Human Development Program, 507266Research Institute of the McGill University Health Center, Montréal, Québec, Canada
| | - A Nadeau
- Department of Pediatric Neurology, University of Sherbrooke, Sherbrooke, Québec, Canada
| | - B Osterman
- Department of Pediatrics, 5622University of Montreal, Montréal, Québec, Canada.,Department of Neurology, CHU Saint-Justine, Montréal, Québec, Canada
| | - I Paradis
- CIUSSS de l'Est-de-l'Île-de-Montréal, CLSC de Rivière-des-Prairies, Montréal, Québec, Canada
| | - D Pohl
- Division of Neurology, 274065Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ontario, Canada
| | - J Reggin
- Department of Pediatric Neurology, Providence Child Neurology, Spokane, Washington, United States
| | - E Riou
- Department of Pediatric Neurology, University of Sherbrooke, Sherbrooke, Québec, Canada
| | - G Roedde
- Latchford Medical Centre, Latchford, Ontario, Canada
| | - E Rossignol
- Brain and Child Development, CHU Saint-Justine Research Center, Montréal, Québec, Canada
| | - G Sébire
- Child Health and Human Development Program, 507266Research Institute of the McGill University Health Center, Montréal, Québec, Canada
| | - M Shevell
- Department of Neurology and Neurosurgery, 54473McGill University, Montréal, Québec Canada.,Department of Pediatrics, 54473McGill University, Montréal, Québec Canada.,Department of Human Genetics, 54473McGill University, Montréal, Québec, Canada.,Child Health and Human Development Program, 507266Research Institute of the McGill University Health Center, Montréal, Québec, Canada
| | - M Srour
- Department of Neurology and Neurosurgery, 54473McGill University, Montréal, Québec Canada.,Department of Pediatrics, 54473McGill University, Montréal, Québec Canada.,Department of Human Genetics, 54473McGill University, Montréal, Québec, Canada.,Child Health and Human Development Program, 507266Research Institute of the McGill University Health Center, Montréal, Québec, Canada
| | - M Sylvain
- Division of Pediatric Neurology, 12369Centre Mère-Enfant Soleil du CHU de Québec-Université Laval, Québec, Canada.,Department of Pediatrics, 12369Centre Mère-Enfant Soleil du CHU de Québec-Université Laval, Québec, Canada
| | - M Tarnopolsky
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - S Venkateswaran
- Department of Pediatrics, CHEO Research Institute, Ottawa, Ontario, Canada
| | - M Sullivan
- Department of Psychology, McGill University, Montréal, Québec, Canada
| | - G Bernard
- Department of Neurology and Neurosurgery, 54473McGill University, Montréal, Québec Canada.,Department of Pediatrics, 54473McGill University, Montréal, Québec Canada.,Department of Human Genetics, 54473McGill University, Montréal, Québec, Canada.,Department of Specialized Medicine, Division of Medical Genetics, 507266McGill University Health Centre, Montréal, Québec, Canada.,Child Health and Human Development Program, 507266Research Institute of the McGill University Health Center, Montréal, Québec, Canada
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Mitchell J, Dall S, Finn D, Sundaramurthy A, Little F, Urquhart W, Evans T, Campbell S, Bedi C. PO-1942: Palliative Radiotherapy Peer Review; A Multidisciplinary retrospective audit. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01959-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Affiliation(s)
| | - W Jones
- Specialist Pharmacist Breastfeeding and Medication, Portsmouth, UK
| | - E Winkley
- Northumbria Healthcare NHS Foundation Trust, UK
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Sef AV, Sef D, Raj B, Day H, Mitchell J, Walker C, Mattison S, McGovern I, Simon A, Kuppurao L. Perioperative transfusion practice in patients undergoing lung transplantation – experience from a 7-year period. J Cardiothorac Vasc Anesth 2020. [DOI: 10.1053/j.jvca.2020.09.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Mitchell J, Jones W, Winkley E, Kinsella SM. Guideline on anaesthesia and sedation in breastfeeding women 2020. Anaesthesia 2020; 75:1482-1493. [DOI: 10.1111/anae.15179] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2020] [Indexed: 12/23/2022]
Affiliation(s)
- J. Mitchell
- Department of Anaesthesia University Hospital Ayr UK
| | - W. Jones
- Breastfeeding and Medication Portsmouth UK
| | - E. Winkley
- Department of Anaesthesia Northumbria NHS Foundation Trust UK
| | - S. M. Kinsella
- Department of Anaesthesia St Michael’s Hospital Bristol UK
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Waller I, Nolan G, Mitchell J, Barry P, Webb A, Jones A. P172 Different spirometry equipment produces clinically important differences in lung function measurements in adults with cystic fibrosis. J Cyst Fibros 2020. [DOI: 10.1016/s1569-1993(20)30507-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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35
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Jecmen D, King R, Gould J, Mitchell J, Ralston K, Burns AI, Bullock A, Grandner MA, Alkozei A, Killgore WD. 0038 The Effects of Morning Blue Light Therapy on Insomnia Severity and PTSD Symptoms in a Clinical Sample. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Individuals with Post Traumatic Stress Disorder (PTSD) often present with insomnia, which may exacerbate other symptoms of the disorder. Morning Blue Light Therapy (BLT) can regulate circadian rhythms and may even improve sleep and mood in individuals with major depressive disorder. However, it is unclear whether morning BLT could also be an effective treatment for the insomnia associated with PTSD. We investigated whether 6 weeks of daily morning BLT would improve insomnia severity and symptom presentation in individuals with PTSD in comparison to a placebo condition of amber light (ALT). We hypothesized that changes in insomnia severity would correlate with improvement in PSTD symptom severity.
Methods
Forty-one participants with a clinical diagnosis of PTSD were randomized to receive 6 weeks of either daily morning BLT (n=22) or ALT (n=19). Insomnia and PTSD symptom severity were evaluated at pre- and post-treatment using the Insomnia Severity Index (ISI) and the Clinician-Administered PTSD Scale (CAPS) for DSM-5, respectively.
Results
Both groups showed a significant decrease in their PTSD symptom severity (p<0.001) and insomnia severity (p<0.001) over the 6-week treatment period. However, improvement in insomnia severity significantly predicted improvements in PTSD symptom severity for the BLT group only (BLT: r =0.542, p=0.009; ALT: r=-0.095, p=0.699). The difference between the two correlation coefficients was significant (Z=-2.07, p=0.039).
Conclusion
The results suggest that morning BLT may be effective in improving PTSD symptoms by regulating the circadian rhythm and improving sleep. While ALT also led to improved PTSD symptom severity, it appears that those changes cannot be explained by improved sleep and may have other underlying mechanisms (e.g., placebo effect). Morning BLT may be a promising adjunctive method to bolster current treatment approaches for PTSD. Because of its ease of administration, it could be easily added to ongoing treatment as usual. This approach warrants further research.
Support
US Army Medical Research and Materiel Command: W81XWH-14-1-0570
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Affiliation(s)
- D Jecmen
- University of Arizona, Tucson, AZ
| | - R King
- University of Arizona, Tucson, AZ
| | - J Gould
- University of Arizona, Tucson, AZ
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King R, Jecmen D, Mitchell J, Ralston K, Gould J, Burns A, Bullock A, Grandner MA, Alkozei A, Killgore WD. 0081 Habitual Sleep Duration is Negatively Correlated with Emotional Reactivity within the Rostral Anterior Cingulate Cortex in Individuals with PTSD. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Sleep difficulties, such as insomnia, are highly prevalent in individuals with Post-Traumatic Stress Disorder (PTSD). However, sleep deprivation can also increase emotional reactivity to positive (as well as negative) stimuli. While the effects of sleep loss on emotional perception healthy individuals has been documented, it remains unclear how lack of sleep in individuals with PTSD may affect their emotional reactivity to positive stimuli. We hypothesized that lower habitual sleep duration would be associated with greater functional brain activation changes in response to subliminally presented happy faces in brain areas of the reward network, such as the rostral anterior cingulate cortex (rACC).
Methods
Thirty-nine individuals with DSM-5 confirmed PTSD were administered the Pittsburgh Sleep Quality Index (PSQI) as a measure of their average nightly sleep duration over the past month. Participants then underwent fMRI imagining while viewing subliminal presentations of faces displaying happiness, using a backward masked facial affect paradigm to minimize conscious awareness of the expressed emotion. Brain activation to masked happy expressions was regressed against sleep duration in SPM12.
Results
There was a negative correlation between habitual sleep duration and activation within the rACC in response to the masked happy faces (x=14,y=40,z=0; k=102, pFWE-corr= 0.008).
Conclusion
Individuals with PTSD who average less sleep at night showed greater emotional reactivity, as indexed by greater functional brain activation changes within an area of the reward network, than individuals who obtained more sleep per night. Future research involving actual sleep duration manipulation will be necessary to determine whether this finding reflects the well-known antidepressant effect of sleep deprivation or a form of greater emotional expression error monitoring among traumatized patients when lacking sleep. Regardless, these findings suggest that insufficient sleep could affect unconsciously perceived emotion in faces and potentially affect social and emotional responses among individuals with PTSD.
Support
US Army Medical Research and Materiel Command: W81XWH-14-1-0570
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Affiliation(s)
- R King
- University of Arizona, Tucson, AZ
| | - D Jecmen
- University of Arizona, Tucson, AZ
| | | | | | - J Gould
- University of Arizona, Tucson, AZ
| | - A Burns
- University of Arizona, Tucson, AZ
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Soder R, Abhyankar S, Morrison M, Weir S, Mitchell J, Dunavin N, Li M, Shune L, Singh A, Ganguly S, Dawn B, McGuirk J. A phase i study to evaluate the safety of wharton's jelly mesenchymal stem cells for the treatment of de novo high risk or steroid refractory acute Graft Versus Host Disease (aGVHD). Cytotherapy 2020. [DOI: 10.1016/j.jcyt.2020.03.188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Behbahani K, Chary A, Mitchell J, Behi A, Prologo J. Abstract No. 618 Percutaneous computed tomography–guided cryoablation of the celiac plexus: a retrospective cohort comparison with ethanol. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Curigliano G, Lenihan D, Fradley M, Ganatra S, Barac A, Blaes A, Herrmann J, Porter C, Lyon AR, Lancellotti P, Patel A, DeCara J, Mitchell J, Harrison E, Moslehi J, Witteles R, Calabro MG, Orecchia R, de Azambuja E, Zamorano JL, Krone R, Iakobishvili Z, Carver J, Armenian S, Ky B, Cardinale D, Cipolla CM, Dent S, Jordan K. Management of cardiac disease in cancer patients throughout oncological treatment: ESMO consensus recommendations. Ann Oncol 2020; 31:171-190. [PMID: 31959335 PMCID: PMC8019325 DOI: 10.1016/j.annonc.2019.10.023] [Citation(s) in RCA: 487] [Impact Index Per Article: 121.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 10/18/2019] [Accepted: 10/21/2019] [Indexed: 12/13/2022] Open
Abstract
Cancer and cardiovascular (CV) disease are the most prevalent diseases in the developed world. Evidence increasingly shows that these conditions are interlinked through common risk factors, coincident in an ageing population, and are connected biologically through some deleterious effects of anticancer treatment on CV health. Anticancer therapies can cause a wide spectrum of short- and long-term cardiotoxic effects. An explosion of novel cancer therapies has revolutionised this field and dramatically altered cancer prognosis. Nevertheless, these new therapies have introduced unexpected CV complications beyond heart failure. Common CV toxicities related to cancer therapy are defined, along with suggested strategies for prevention, detection and treatment. This ESMO consensus article proposes to define CV toxicities related to cancer or its therapies and provide guidance regarding prevention, screening, monitoring and treatment of CV toxicity. The majority of anticancer therapies are associated with some CV toxicity, ranging from asymptomatic and transient to more clinically significant and long-lasting cardiac events. It is critical however, that concerns about potential CV damage resulting from anticancer therapies should be weighed against the potential benefits of cancer therapy, including benefits in overall survival. CV disease in patients with cancer is complex and treatment needs to be individualised. The scope of cardio-oncology is wide and includes prevention, detection, monitoring and treatment of CV toxicity related to cancer therapy, and also ensuring the safe development of future novel cancer treatments that minimise the impact on CV health. It is anticipated that the management strategies discussed herein will be suitable for the majority of patients. Nonetheless, the clinical judgment of physicians remains extremely important; hence, when using these best clinical practices to inform treatment options and decisions, practitioners should also consider the individual circumstances of their patients on a case-by-case basis.
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Affiliation(s)
- G. Curigliano
- European Institute of Oncology IRCCS, Milan
- Department of Oncology and Haematology (DIPO), University of Milan, Milan, Italy
| | - D. Lenihan
- Cardiovascular Division, Cardio-Oncology Center of Excellence, Washington University Medical Center, St. Louis
| | - M. Fradley
- Cardio-oncology Program, Division of Cardiovascular Medicine, Morsani College of Medicine and H. Lee Moffitt Cancer Center and Research Institute, University of South Florida, Tampa
| | - S. Ganatra
- Cardio-Oncology Program, Lahey Medical Center, Burlington
| | - A. Barac
- Cardio-Oncology Program, Medstar Heart and Vascular Institute and MedStar Georgetown Cancer Institute, Georgetown University Hospital, Washington DC
| | - A. Blaes
- Division of Hematology, Oncology and Transplantation, University of Minnesota, Minneapolis
| | | | - C. Porter
- University of Kansas Medical Center, Lawrence, USA
| | - A. R. Lyon
- Royal Brompton Hospital and Imperial College, London, UK
| | - P. Lancellotti
- GIGA Cardiovascular Sciences, Acute Care Unit, Heart Failure Clinic, CHU Sart Tilman, University Hospital of Liège, Liège, Belgium
| | - A. Patel
- Morsani College of Medicine, University of South Florida, Tampa
| | - J. DeCara
- Medicine Section of Cardiology, University of Chicago, Chicago
| | - J. Mitchell
- Washington University Medical Center, St. Louis
| | - E. Harrison
- HCA Memorial Hospital and University of South Florida, Tampa
| | - J. Moslehi
- Vanderbilt University School of Medicine, Nashville
| | - R. Witteles
- Division of Cardiovascular Medicine, Falk CVRC, Stanford University School of Medicine, Stanford, USA
| | - M. G. Calabro
- Department of Anesthesia and Intensive Care, IRCCS, San Raffaele Scientific Institute, Milan, Italy
| | | | - E. de Azambuja
- Institut Jules Bordet and L’Université Libre de Bruxelles, Brussels, Belgium
| | | | - R. Krone
- Division of Cardiology, Washington University, St. Louis, USA
| | - Z. Iakobishvili
- Clalit Health Services, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - J. Carver
- Division of Cardiology, Abramson Cancer Center, Hospital of the University of Pennsylvania, Philadelphia
| | - S. Armenian
- Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte
| | - B. Ky
- University of Pennsylvania School of Medicine, Philadelphia, USA
| | - D. Cardinale
- Cardioncology Unit, European Institute of Oncology, IRCCS, Milan
| | - C. M. Cipolla
- Cardiology Department, European Institute of Oncology, IRCCS, Milan, Italy
| | - S. Dent
- Duke Cancer Institute, Duke University, Durham, USA
| | - K. Jordan
- Department of Medicine V, Hematology, Oncology and Rheumatology, University of Heidelberg, Heidelberg, Germany
| | - ESMO Guidelines Committee
- Correspondence to: ESMO Guidelines Committee, ESMO Head Office, Via Ginevra 4, CH-6900 Lugano, Switzerland, (ESMO Guidelines Committee)
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Sosinsky A, Ambrose J, Zarowiecki M, Mitchell J, Henderson S, Murugaesu N, Hamblin A, Turnbull C, Walker S, Perez-Gil D, Rueda-Martin A, Fowler T, Caulfield M, Rendon A. 100,000 genomes project: Integrating whole genome sequencing (WGS) data into clinical practice. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz413.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Galoin Bertail C, Perouse De Montclos T, Bakloul M, Metton O, Mitchell J, Ninet J, Di Filippo S. P4375Value of echocardiography to diagnose coronary arteries patterns in transposition of great arteries. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
The objective of this study was to evaluate the accuracy of echocardiographic to assess coronary arteries (CA) anatomy in transposition of the great arteries (TGA) and determine impact on outcomes.
Material and methods
Retrospective analysis of data in neonates diagnosed with TGA (isolated or associated with VSD). Preoperative echocardiographic (TTE) coronary artery pattern and surgical intraoperative reports (SURG) were compared. Mismatch between TTE and SURG, and its impact on perioperative outcome were assessed. Coronary patterns were classified in 4 groups: I= normal CA, II= CA with intramural course, III= CA loop, IV= CA loop and intramural segment.
Results
108 neonates who underwent arterial switch operation (ASO) for isolated TGA (67 cases) or TGA+VSD (41) were included in the study: 68 ranged in group I, 7 in group II, 32 in group III and 1 in group IV. Five patients died (4.6%), from coronary cause in 3. Survival rates were 96% at 1-month and 95.2% beyond. Intraoperative complications occurred in 10 cases. TTE and SURG CA diagnosis differed in 19 cases = 17.6% (mismatch). Diagnosis of CA anatomy differed in 4.4%, 42.8%, 37.5% and 100% of respectively groups I, II, III and IV. Mortality was 28.6% in group II (intramural CA) compared to 2.9% in group I, 3.1% in group III and 0% in group IV (p=0.002). Death rates was 15.8% if TTE/SURG mismatch and 2.2% if TTE and SURG were concordant (p=0.0108). Mortality in group II (intramural CA) increased up to 50% in case of mismach TTE/SURG versus 0% if concordance, and was similar in the other groups. Survival rates were 84.2% in TTE misdiagnosed CA anomalies compared to 97.6% if TTE assessment correlated with surgical reports. By multivariate analysis, groups II and III coronary anatomy were risk factors for mismatch between TTE and SURG (respectively p=0.008 and p=0.0005), and mismatch TTE/SURG was the only risk factor for perioperative mortality (p=0.045).
Conclusion
Echocardiography can accurately assess coronary artery anatomy in neonates with TGA. Intramural coronary course is often misdiagnosed. Missed diagnosis of coronary artery anomaly preoperatively may impact on perioperative mortality.
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Affiliation(s)
- C Galoin Bertail
- University Hospital of Lyon - Hospital Louis Pradel, Lyon, France
| | | | - M Bakloul
- University Hospital of Lyon - Hospital Louis Pradel, Lyon, France
| | - O Metton
- University Hospital of Lyon - Hospital Louis Pradel, Lyon, France
| | - J Mitchell
- University Hospital of Lyon - Hospital Louis Pradel, Lyon, France
| | - J Ninet
- University Hospital of Lyon - Hospital Louis Pradel, Lyon, France
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Mitchell J, Belcher E. PL03.01 Establishing a Nurse Led Follow-Up Service for Patients With Resected Early Stage Lung Cancer. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Hubbard J, Cremolini C, Graham R, Moretto R, Mitchell J, Wessling J, Tőke E, Csiszovszki Z, Lorincz O, Molnar L, Somogyi E, Megyesi M, Pántya K, Toth J, Pales P, Miklos I, Falcone A. Evaluation of safety, immunogenicity and preliminary efficacy of PolyPEPI1018 vaccine in subjects with metastatic colorectal cancer (mCRC) with a predictive biomarker. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz246.083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Rochat TJ, Houle B, Stein A, Mitchell J, Bland RM. Maternal alcohol use and children's emotional and cognitive outcomes in rural South Africa. S Afr Med J 2019; 109:526-534. [PMID: 31266581 DOI: 10.7196/samj.2019.v109i7.13120] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Alcohol use in South Africa (SA) is increasing. The World Health Organization (WHO) states that SA is the third-largest drinking population in Africa, with the highest rate of fetal alcohol syndrome in the world. Internationally, parental drinking during childhood is a risk factor for poor child mental health, behavioural problems and weaker educational outcomes in middle childhood. However, parental alcohol use in Africa is under-researched, and much of the literature on maternal alcohol consumption is restricted to clinical and pregnancy samples. OBJECTIVES To investigate alcohol use and hazardous drinking (HD) among mothers/primary caregivers of children aged 7 - 11 years in a rural SA cohort. We explored risk factors for drinking and the association between HD and child behaviour/cognition. METHODS The primary outcome measure was the WHO Alcohol Use Disorder Identification Test (AUDIT) using the standardised cut-off for HD (≥8). Secondary measures were the Patient Health Questionnaire Depression Scale (PHQ-9), Patient Health Questionnaire General Anxiety Disorder Scale (GAD-7), Parenting Stress Index, short form (PSI-36), Child Behaviour Checklist (CBCL, parent reported), Kaufman Developmental Assessment Battery (KABC-II) for child cognition, and Neuropsychological Assessment Battery, 2nd edition, subtests (NEPSY-II) for executive function. We compared characteristics of those drinking/not drinking, using χ2 tests, and modelled outcomes on parenting stress, cognitive outcomes and CBCL scores for children using logistic regression analysis. We grouped mothers/caregivers engaged in HD to examine its effect on parent/child outcomes using t-tests to test for significant differences. RESULTS Of 1 505 women (1 266 mothers and 239 caregivers) with 1 536 children, 12% reported consuming alcohol and 3% reported HD. Higher maternal/caregiver age (31 - 40 years, adjusted odds ratio (aOR) 0.57 (95% confidence interval (CI) 0.4 - 0.9); >41 years, aOR 0.30 (95% CI 0.2 - 0.5)), education (matriculation, aOR 0.49 (95% CI 0.3 - 0.9); post matriculation, aOR 0.30 (95% CI 0.1 - 0.6)), and a stable relationship with the father (aOR 0.6 (95% CI 0.4 - 1.0)) were associated with no alcohol use. Food insecurity increased the odds of alcohol use (aOR 1.52 (95% CI 1.1 - 2.1)), while parental mental health (parenting stress, anxiety) and child mental health problems were associated with approximately double the odds of consuming alcohol in univariate analysis. Children of HD mothers/caregivers had higher mean scores for psychological problems (CBCL total score: no HD (mean 45.0) v. HD (mean 48.9); p=0.029) and lower cognitive scores (KABC Learning Scale: no HD (mean 14.3) v. HD (mean 12.8); p=0.017). CONCLUSIONS While HD rates were low, maternal/caregiver alcohol use negatively impacted on parenting and children's behavioural/cognitive outcomes. International evidence suggests that integrated approaches engaging parents and families may be more effective for parent-child outcomes than individual psychiatric or medical care for the parent on their own.
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Affiliation(s)
- T J Rochat
- Africa Health Research Institute, Durban, South Africa; MRC/Wits Developmental Pathways to Health Research Unit, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
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Darwish L, Nguyen MM, Saleem M, Eakin KA, Herrmann N, Sugamori KS, Oh PI, Yang P, Mitchell J, Lanctôt KL, Swardfager W. Lower serum osteocalcin concentrations in patients with type 2 diabetes and relationships with vascular risk factors among patients with coronary artery disease. J Diabetes Complications 2019; 33:390-397. [PMID: 30799280 DOI: 10.1016/j.jdiacomp.2019.01.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 01/11/2019] [Accepted: 01/13/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Lower serum concentrations of the osteoblast-derived protein, osteocalcin, have been associated with poorer glycemic control, insulin resistance and atherosclerosis, and with the development of type 2 diabetes (T2DM). METHODS This study compares concentrations of two physiological forms of osteocalcin, carboxylated (cOCN) and uncarboxylated (unOCN), between participants with T2DM (n = 20) and age-, gender- and body mass index (BMI)-matched participants without T2DM (n = 40) among patients with coronary artery disease (CAD), and it explores relationships between osteocalcin concentrations and cardiovascular risk factors. RESULTS Concentrations of unOCN (2.71 ± 1.86 vs. 4.70 ± 2.03 ng/mL; t = -3.635, p = 0.001) and cOCN (8.70 ± 2.27 vs. 10.77 ± 3.69 ng/mL; t = -2.30, p = 0.025) were lower in participants with T2DM. In participants without T2DM, concentrations of cOCN were associated with fitness (VO2Peak rho = 0.317, p = 0.047) and lower body fat (rho = -0.324, p = 0.041). In participants with T2DM, lower unOCN was associated with HbA1c (rho = -0.516, p = 0.020). Higher body mass was associated with higher unOCN (rho = 0.423, p = 0.009) in participants without T2DM, but with lower concentrations of both unOCN (rho = -0.590, p = 0.006) and cOCN (rho = -0.632, p = 0.003) in participants with T2DM. CONCLUSION In patients with CAD, lower osteocalcin concentrations were related to type 2 diabetes, and to adverse fitness, metabolic and obesity profiles.
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Affiliation(s)
- L Darwish
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Canada; Department of Pharmacology & Toxicology, University of Toronto, Toronto, Canada; Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute, Toronto, Canada; University Health Network Toronto Rehabilitation Institute, Toronto, Canada
| | - M M Nguyen
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Canada; Department of Pharmacology & Toxicology, University of Toronto, Toronto, Canada; Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute, Toronto, Canada; University Health Network Toronto Rehabilitation Institute, Toronto, Canada
| | - M Saleem
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Canada; University Health Network Toronto Rehabilitation Institute, Toronto, Canada; Neuropsychopharmacology Research Group, Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - K A Eakin
- HBSc Program, Queen's University, Kingston, Ontario, Canada
| | - N Herrmann
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Canada; Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute, Toronto, Canada; Neuropsychopharmacology Research Group, Sunnybrook Research Institute, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada
| | - K S Sugamori
- Department of Pharmacology & Toxicology, University of Toronto, Toronto, Canada
| | - P I Oh
- University Health Network Toronto Rehabilitation Institute, Toronto, Canada
| | - P Yang
- Sunnybrook Academic Family Health Team, Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - J Mitchell
- Department of Pharmacology & Toxicology, University of Toronto, Toronto, Canada
| | - K L Lanctôt
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Canada; Department of Pharmacology & Toxicology, University of Toronto, Toronto, Canada; Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute, Toronto, Canada; University Health Network Toronto Rehabilitation Institute, Toronto, Canada; Neuropsychopharmacology Research Group, Sunnybrook Research Institute, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada
| | - W Swardfager
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Canada; Department of Pharmacology & Toxicology, University of Toronto, Toronto, Canada; Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute, Toronto, Canada; University Health Network Toronto Rehabilitation Institute, Toronto, Canada.
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Windsor J, Ramanarasiah T, Burke M, Mitchell J. EP-1297 Heart of the Matter: A study of 112 left breast cancer patients treated with DIBH. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31717-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Rooney M, Mitchell J, McLaren D, Nailon W. EP-1932 Development of a deep learning network using a pre-trained convolutional neural network. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)32352-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Johnson C, Mitchell J, Manyapu S, Hawkins C, Singer A, Prologo J. 04:12 PM Abstract No. 401 Natural history of motor nerve cryoablation: a retrospective cohort analysis. J Vasc Interv Radiol 2019. [DOI: 10.1016/j.jvir.2018.12.477] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Bagla S, Levy J, Hopkins T, Massari F, Vogel A, Bress A, Dixon R, Mitchell J, Sunenshine P, Barr J, Tran N, Morris J, Berrier H, Brelje T, Schwartz K. Abstract No. 618 Rapid pain improvement in patients treated for painful bone metastases with the Medtronic Osteocool RF Ablation system: the OPuS One study. J Vasc Interv Radiol 2019. [DOI: 10.1016/j.jvir.2018.12.723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Adli E, Ahuja A, Apsimon O, Apsimon R, Bachmann AM, Barrientos D, Barros MM, Batkiewicz J, Batsch F, Bauche J, Berglyd Olsen VK, Bernardini M, Biskup B, Boccardi A, Bogey T, Bohl T, Bracco C, Braunmüller F, Burger S, Burt G, Bustamante S, Buttenschön B, Caldwell A, Cascella M, Chappell J, Chevallay E, Chung M, Cooke D, Damerau H, Deacon L, Deubner LH, Dexter A, Doebert S, Farmer J, Fedosseev VN, Fior G, Fiorito R, Fonseca RA, Friebel F, Garolfi L, Gessner S, Gorgisyan I, Gorn AA, Granados E, Grulke O, Gschwendtner E, Guerrero A, Hansen J, Helm A, Henderson JR, Hessler C, Hofle W, Hüther M, Ibison M, Jensen L, Jolly S, Keeble F, Kim SY, Kraus F, Lefevre T, LeGodec G, Li Y, Liu S, Lopes N, Lotov KV, Maricalva Brun L, Martyanov M, Mazzoni S, Medina Godoy D, Minakov VA, Mitchell J, Molendijk JC, Mompo R, Moody JT, Moreira M, Muggli P, Mutin C, Öz E, Ozturk E, Pasquino C, Pardons A, Peña Asmus F, Pepitone K, Perera A, Petrenko A, Pitman S, Plyushchev G, Pukhov A, Rey S, Rieger K, Ruhl H, Schmidt JS, Shalimova IA, Shaposhnikova E, Sherwood P, Silva LO, Soby L, Sosedkin AP, Speroni R, Spitsyn RI, Tuev PV, Turner M, Velotti F, Verra L, Verzilov VA, Vieira J, Vincke H, Welsch CP, Williamson B, Wing M, Woolley B, Xia G. Experimental Observation of Proton Bunch Modulation in a Plasma at Varying Plasma Densities. Phys Rev Lett 2019; 122:054802. [PMID: 30822008 DOI: 10.1103/physrevlett.122.054802] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Indexed: 06/09/2023]
Abstract
We give direct experimental evidence for the observation of the full transverse self-modulation of a long, relativistic proton bunch propagating through a dense plasma. The bunch exits the plasma with a periodic density modulation resulting from radial wakefield effects. We show that the modulation is seeded by a relativistic ionization front created using an intense laser pulse copropagating with the proton bunch. The modulation extends over the length of the proton bunch following the seed point. By varying the plasma density over one order of magnitude, we show that the modulation frequency scales with the expected dependence on the plasma density, i.e., it is equal to the plasma frequency, as expected from theory.
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Affiliation(s)
- E Adli
- University of Oslo, 0316 Oslo, Norway
| | - A Ahuja
- CERN, 1211 Geneva, Switzerland
| | - O Apsimon
- University of Manchester, M13 9PL Manchester, United Kingdom
- Cockcroft Institute, WA4 4AD Daresbury, United Kingdom
| | - R Apsimon
- Cockcroft Institute, WA4 4AD Daresbury, United Kingdom
- Lancaster University, LA1 4YB Lancaster, United Kingdom
| | - A-M Bachmann
- CERN, 1211 Geneva, Switzerland
- Max Planck Institute for Physics, 80805 Munich, Germany
- Technical University Munich, 80333 Munich, Germany
| | | | | | | | - F Batsch
- CERN, 1211 Geneva, Switzerland
- Max Planck Institute for Physics, 80805 Munich, Germany
- Technical University Munich, 80333 Munich, Germany
| | | | | | | | | | | | - T Bogey
- CERN, 1211 Geneva, Switzerland
| | - T Bohl
- CERN, 1211 Geneva, Switzerland
| | | | - F Braunmüller
- Max Planck Institute for Physics, 80805 Munich, Germany
| | | | - G Burt
- Cockcroft Institute, WA4 4AD Daresbury, United Kingdom
- Lancaster University, LA1 4YB Lancaster, United Kingdom
| | | | - B Buttenschön
- Max Planck Institute for Plasma Physics, 17491 Greifswald, Germany
| | - A Caldwell
- Max Planck Institute for Physics, 80805 Munich, Germany
| | | | | | | | - M Chung
- UNIST, 44919 Ulsan, Republic of Korea
| | - D Cooke
- UCL, WC1E 6BT London, United Kingdom
| | | | - L Deacon
- UCL, WC1E 6BT London, United Kingdom
| | - L H Deubner
- Philipps-Universität Marburg, 35032 Marburg, Germany
| | - A Dexter
- Cockcroft Institute, WA4 4AD Daresbury, United Kingdom
- Lancaster University, LA1 4YB Lancaster, United Kingdom
| | | | - J Farmer
- Heinrich-Heine-University of Düsseldorf, 40225 Düsseldorf, Germany
| | | | - G Fior
- Max Planck Institute for Physics, 80805 Munich, Germany
| | - R Fiorito
- Cockcroft Institute, WA4 4AD Daresbury, United Kingdom
- University of Liverpool, L69 7ZE Liverpool, United Kingdom
| | - R A Fonseca
- ISCTE-Instituto Universitéario de Lisboa, 1649-026 Lisbon, Portugal
| | | | | | | | | | - A A Gorn
- Budker Institute of Nuclear Physics SB RAS, 630090 Novosibirsk, Russia
- Novosibirsk State University, 630090 Novosibirsk, Russia
| | | | - O Grulke
- Max Planck Institute for Plasma Physics, 17491 Greifswald, Germany
- Technical University of Denmark, 2800 Lyngby, Denmark
| | | | | | | | - A Helm
- GoLP/Instituto de Plasmas e Fusão Nuclear, Instituto Superior Técnico, Universidade de Lisboa, 1049-001 Lisbon, Portugal
| | - J R Henderson
- Cockcroft Institute, WA4 4AD Daresbury, United Kingdom
- Lancaster University, LA1 4YB Lancaster, United Kingdom
| | | | - W Hofle
- CERN, 1211 Geneva, Switzerland
| | - M Hüther
- Max Planck Institute for Physics, 80805 Munich, Germany
| | - M Ibison
- Cockcroft Institute, WA4 4AD Daresbury, United Kingdom
- University of Liverpool, L69 7ZE Liverpool, United Kingdom
| | | | - S Jolly
- UCL, WC1E 6BT London, United Kingdom
| | - F Keeble
- UCL, WC1E 6BT London, United Kingdom
| | - S-Y Kim
- UNIST, 44919 Ulsan, Republic of Korea
| | - F Kraus
- Philipps-Universität Marburg, 35032 Marburg, Germany
| | | | | | - Y Li
- University of Manchester, M13 9PL Manchester, United Kingdom
- Cockcroft Institute, WA4 4AD Daresbury, United Kingdom
| | - S Liu
- TRIUMF, V6T 2A3 Vancouver, Canada
| | - N Lopes
- GoLP/Instituto de Plasmas e Fusão Nuclear, Instituto Superior Técnico, Universidade de Lisboa, 1049-001 Lisbon, Portugal
| | - K V Lotov
- Budker Institute of Nuclear Physics SB RAS, 630090 Novosibirsk, Russia
- Novosibirsk State University, 630090 Novosibirsk, Russia
| | | | - M Martyanov
- Max Planck Institute for Physics, 80805 Munich, Germany
| | | | | | - V A Minakov
- Budker Institute of Nuclear Physics SB RAS, 630090 Novosibirsk, Russia
- Novosibirsk State University, 630090 Novosibirsk, Russia
| | - J Mitchell
- Cockcroft Institute, WA4 4AD Daresbury, United Kingdom
- Lancaster University, LA1 4YB Lancaster, United Kingdom
| | | | - R Mompo
- CERN, 1211 Geneva, Switzerland
| | - J T Moody
- Max Planck Institute for Physics, 80805 Munich, Germany
| | - M Moreira
- CERN, 1211 Geneva, Switzerland
- GoLP/Instituto de Plasmas e Fusão Nuclear, Instituto Superior Técnico, Universidade de Lisboa, 1049-001 Lisbon, Portugal
| | - P Muggli
- CERN, 1211 Geneva, Switzerland
- Max Planck Institute for Physics, 80805 Munich, Germany
| | - C Mutin
- CERN, 1211 Geneva, Switzerland
| | - E Öz
- Max Planck Institute for Physics, 80805 Munich, Germany
| | | | | | | | - F Peña Asmus
- Max Planck Institute for Physics, 80805 Munich, Germany
- Technical University Munich, 80333 Munich, Germany
| | | | - A Perera
- Cockcroft Institute, WA4 4AD Daresbury, United Kingdom
- University of Liverpool, L69 7ZE Liverpool, United Kingdom
| | - A Petrenko
- CERN, 1211 Geneva, Switzerland
- Budker Institute of Nuclear Physics SB RAS, 630090 Novosibirsk, Russia
| | - S Pitman
- Cockcroft Institute, WA4 4AD Daresbury, United Kingdom
- Lancaster University, LA1 4YB Lancaster, United Kingdom
| | | | - A Pukhov
- Heinrich-Heine-University of Düsseldorf, 40225 Düsseldorf, Germany
| | - S Rey
- CERN, 1211 Geneva, Switzerland
| | - K Rieger
- Max Planck Institute for Physics, 80805 Munich, Germany
| | - H Ruhl
- Ludwig-Maximilians-Universität, 80539 Munich, Germany
| | | | - I A Shalimova
- Novosibirsk State University, 630090 Novosibirsk, Russia
- Institute of Computational Mathematics and Mathematical Geophysics SB RAS, 630090 Novosibirsk, Russia
| | | | | | - L O Silva
- GoLP/Instituto de Plasmas e Fusão Nuclear, Instituto Superior Técnico, Universidade de Lisboa, 1049-001 Lisbon, Portugal
| | - L Soby
- CERN, 1211 Geneva, Switzerland
| | - A P Sosedkin
- Budker Institute of Nuclear Physics SB RAS, 630090 Novosibirsk, Russia
- Novosibirsk State University, 630090 Novosibirsk, Russia
| | | | - R I Spitsyn
- Budker Institute of Nuclear Physics SB RAS, 630090 Novosibirsk, Russia
- Novosibirsk State University, 630090 Novosibirsk, Russia
| | - P V Tuev
- Budker Institute of Nuclear Physics SB RAS, 630090 Novosibirsk, Russia
- Novosibirsk State University, 630090 Novosibirsk, Russia
| | | | | | - L Verra
- CERN, 1211 Geneva, Switzerland
- University of Milan, 20122 Milan, Italy
| | | | - J Vieira
- GoLP/Instituto de Plasmas e Fusão Nuclear, Instituto Superior Técnico, Universidade de Lisboa, 1049-001 Lisbon, Portugal
| | | | - C P Welsch
- Cockcroft Institute, WA4 4AD Daresbury, United Kingdom
- University of Liverpool, L69 7ZE Liverpool, United Kingdom
| | - B Williamson
- University of Manchester, M13 9PL Manchester, United Kingdom
- Cockcroft Institute, WA4 4AD Daresbury, United Kingdom
| | - M Wing
- UCL, WC1E 6BT London, United Kingdom
| | | | - G Xia
- University of Manchester, M13 9PL Manchester, United Kingdom
- Cockcroft Institute, WA4 4AD Daresbury, United Kingdom
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